Targetoid Polycyclic Concentric Hair Regrowth Pattern Is a Sign of Immunological Recovery in Alopecia Areata

Abstract

Background : Alopecia areata is a common autoimmune disease, where there are many topical and systemic therapies, during which hair growth appears in a uniform pattern. In certain cases, hair regrowth takes a polycyclic pattern simulating a target, so called targetoid phenomena. Objective: To screen all cases of treated alopecia areata for hair targetoid regrowth pattern. Methods: This is an observational study, was conducted in Dermatology Department of Baghdad Teaching Hospital in Iraq, during the period, August 2017 to October 2017 . All cases treated for alopecia areata with IM triamcinolone 20 - 40 mg injection every 2 weeks with topical clobetasone ointment and zinc sulfate 2 mg/kg/day for 2 months, were examined for the targetoid concentric hair regrowth pattern. Result: Among all cases of alopecia areata, seven patients were recorded to have the targetoid concentric hair pattern, which seen 2 - 4 weeks after therapy, their ages ranged from 4 to 25 years old with a mean 14.5, all of them were males. All these patients returned back with hair growth in a form of rings of hair growth alternating with rings of little or no hair growth forming a typical picture of target. Conclusion: Targetoid polycyclic concentric hair regrowth pattern is an important phenomenon seen in patients receiving treatment for alopecia areata, which is a good sign of recovery where its etiopathogenesis could not well be elucidated but alternating immunological reactions could explain this targetoid pattern.