CLINICAL-EPIDEMIOLOGIC STUDY OF ALOPECIA-AREATA

Background. Alopecia areata is a common disease and may be associated with autoimmune disease, atopy, Down syndrome, emotional stress, and f oci of sepsis. Methods. Seven cases of alopecia areata were diagnosed among workers in the Water and Effluent Treatment Sector (WETS) Of a p aper factory, representing a 0.6% incidence, when the value for the po pulation at large is 0.1%. Three of these workers are assigned to the WETS on a permanent basis and four provide maintenance services. One o f the latter patients had alopecia areata that fully regressed. Becaus e biologic treatment of water and effluents involves saprophytic bacte ria and fungi as well as chemical substances such as acrylamide, a cli nical examination and laboratory tests were performed on all workers a ssigned permanently to the WETS (N = 9) and on 25% of the workers, sel ected at random providing services to the sector (N = 14). Results. Th ere was no association between alopecia areata and atopy, dermatophyto sis, or bacteria isolated. Toxicologic evaluation revealed an acrylami de-like substance in 7 workers with alopecia areata, with a statistica lly significant correlation. Measures were taken at the workplace to d ecrease worker contact with the mists (probably containing acrylamide) in the pulp-pressing room; no other cases of alopecia areata had been detected 1 year after the study. Conclusions. A survey of the literat ure did not show reports of alopecia areata as an occupational dermato sis, but our conclusion is, that this dermatosis could be due to the p rofessional activities of the workers at the paper factory studied.