Hideo Nakayama* and KoRon Chen
Metal allergy was found with severe types of alopecia areata (AA) at the rate of 69.9% and the elimination of metal allergens from dental metals, cooking instruments lead to satisfactory hair regrowth and prevention of severe relapse of AA for the period of in average four years and four months at the rate of 75.5%. The cooperation of dentists for analysis of dental metals, removing allergic alloys and replacing to ceramics were needed. Another causation of AA was type I and IV allergy to house dust mite (HDM). This type has been called atopic alopecia historically. There is enough evidence that HDM is the main causation of atopic dermatitis (AD). Severe and intractable AD could be cured by the mite fauna investigation by methylene blue agar (MBA) method, followed by environmental improvement to decrease mites to less than 50/m2 everywhere in the home. The same solution was applied to treat severe atopic alopecia cases, which were cured at the rate of 58.3%, and the longest record of confirmed period of cure was five years. When six years or more elapsed after the onset of AA, any kind of treatment was not successful, because biopsy of the scalp revealed the disappearance of hair follicles, which was replaced by dermal fibrosis. Therefore, the treatment of AA should start quickly, investigating allergy to metals and HDM.
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