Alopecia areata totalis is a variant of alopecia areata, a common autoimmune disorder resulting in non-scarring hair loss. Although its pathogenesis remains unclear, both genetic predisposition and environmental triggers have been implicated, of which chronic inflammatory and infectious conditions are considered potential contributors through persistent immune stimulation. This report presents a case of alopecia areata totalis in a five-year-old female patient who presented with extensive untreated dental caries and chronic oral infection. The patient underwent comprehensive dental rehabilitation under general anesthesia, which included elimination of all infectious foci and restoration of oral health. Notably, a marked hair regrowth was observed during follow-up, in the absence of ongoing dermatological treatment, highlighting the possible association between chronic oral infection and alopecia areata. This case highlights the potential role of chronic oral infection as a contributing environmental trigger in alopecia areata and emphasizes the importance of a multidisciplinary approach in the management of pediatric patients with autoimmune conditions.
Samra et al. (Sun,) studied this question.