title: Alternaria scalp infection in a patient with alopecia areata. Coexistence or causative relationship?
abstract: BACKGROUND
  Alopecia areata is an autoimmune disease that is affecting anagen hair follicles. The triggers of autoimmunity in patients with alopecia areata remain unknown.
  
  
  METHODS
  A 13-year-old boy developed multiple hairless patches of focal hair loss with typical clinical and trichoscopy features of alopecia areata. Mycology examination of the scalp hair and epidermal scrapings reveled massive growth of Alternaria chlamydospora.
  
  
  CONCLUSIONS
  We hypothesize that fungal antigens (e.g. antigens involved in fungal melanin synthesis) may be possible triggers, contributing to autoimmune reactions in patients with alopecia areata. We discuss research data, which may indirectly support this hypothesis, however the concept has yet to be verified.
authors: Department of Dermatology CSK MSW, Warsaw, Poland  ; Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland  ; Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland.
authors: Lidia
authors: L
authors: Rudnicka
authors: Malgorzata
authors: M
authors: Lukomska
keywords: Alternaria; IgE; Wood’s light; allergy; alopecia areata; autoimmunity; dermoscopy; fluorescence; fungus; hair; infection; melanin; pathogenesis; phaeohyphomycosis; tines capitis; trichoscopy