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Alopecia areata. How not to miss Satoyoshi syndrome?
Lidia Rudnicka,
Małgorzata Kwiatkowska,
Adriana Rakowska,
Joanna Czuwara,
Małgorzata Olszewska,
Lidia Rudnicka
Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
Department of Neuropeptides, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
Search for more papers by this authorMałgorzata Kwiatkowska
Department of Dermatology, CSK MSW, Warsaw, Poland
Search for more papers by this authorAdriana Rakowska
Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
Search for more papers by this authorJoanna Czuwara
Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
Search for more papers by this authorCorresponding Author
Małgorzata Olszewska
Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
Correspondence: Malgorzata Olszewska, M.D., Ph.D., Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008 Warsaw, Poland. Email: [email protected]Search for more papers by this authorLidia Rudnicka,
Małgorzata Kwiatkowska,
Adriana Rakowska,
Joanna Czuwara,
Małgorzata Olszewska,
Lidia Rudnicka
Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
Department of Neuropeptides, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
Search for more papers by this authorMałgorzata Kwiatkowska
Department of Dermatology, CSK MSW, Warsaw, Poland
Search for more papers by this authorAdriana Rakowska
Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
Search for more papers by this authorJoanna Czuwara
Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
Search for more papers by this authorCorresponding Author
Małgorzata Olszewska
Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
Correspondence: Malgorzata Olszewska, M.D., Ph.D., Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008 Warsaw, Poland. Email: [email protected]Search for more papers by this authorAbstract
Satoyoshi syndrome is a multisystem disorder of suspected autoimmune etiology, characterized predominantly by alopecia, muscle spasms and diarrhea. Antinuclear antibodies are present in 60% of patients. The syndrome primarily affects girls and young women. Trichoscopy shows regularly distributed yellow dots, indistinguishable from typical alopecia areata. The condition may be easily misdiagnosed and treated as alopecia areata. On the basis of an in-depth analysis of all published cases we developed diagnostic criteria for Satoyoshi syndrome. We also suggest that two subtypes of the disorder should be distinguished, the ANA-positive Satoyoshi syndrome with generally good response to systemic glucocorticosteroid therapy and the ANA-negative Satoyoshi with less favorable prognosis. In our opinion all patients will alopecia areata (in particular alopecia totalis) should be inquired about muscle spasms and diarrhea and tested for antinuclear antibodies to decrease the risk of missing Satoyoshi syndrome.
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