[Value of pathologic thyroid gland findings in alopecia areata]

As we had frequently found goiters in patients with alopecia areata, we performed specific thyroid diagnostics in 120 patients suffering from this kind of loss of hair. By means of palpatory, sonographic, and scintigraphic examination of the thyroid gland, we found in 18% no goiters, in 70% diffuse goiters, and in 12% nodular goiters. In 115 patients, the metabolic condition showed euthyroidism, 3 patients had subclinical hypothyroidism, and 2 patients subclinical hyperthyroidism. We did not detect any increased incidence of antibodies against thyroglobulin or thyroid microsomes; only one patient showed Hashimoto's thyroiditis. The resected goiter tissue of 3 patients with thyroid enlargement and alopecia areata predominantly revealed the typical regressive changes usually seen in colloid and common goiters. But, contrary to the scalp biopsies, the goiter tissue only showed slight antigen expression of HLA-DR. On account of the high incidence of non-toxic diffuse goiters, we discuss the possibility of a goitrogenic factor associated with alopecia areata.