Alopecia Areata Associated with Graves' Disease

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Alopecia areata (AA) is usually characterized by areas of patchy hair loss on the scalp, although in severe cases, the total loss of scalp or body hair may occur. While the association between AA and Graves' disease is described in textbooks, few reports have been published. We herein report a case of AA associated with Graves' disease, in which a skin biopsy revealed marked perifollicular infiltration of mononuclear cells and pigment incontinence in the dermis. Slight staining of IgG and IgM was observed in the follicle on a direct immunofluorescence test. Pulse corticosteroid therapy followed by contact immunotherapy with squaric acid dibutylester (SADBE) was effective.