@article{3054309,
    title = "Alopecia areata and affected skin CRH receptor upregulation induced by
acute emotional stress",
    author = "Katsarou-Katsari, A and Singh, LK and Theoharides, TC",
    journal = "Dermatology World",
    year = "2001",
    volume = "203",
    number = "2",
    pages = "157-161",
    publisher = "Karger",
    doi = "10.1159/000051732",
    keywords = "alopecia; corticotropin-releasing hormone; mast cells; inflammation;
stress",
    abstract = "Background. Recent evidence indicates that acute stress can precipitate
a number of dermatological conditions, including alopecia areata. This
effect may be mediated by corticotropin-releasing hormone (CRH) released
locally in the skin from dorsal root ganglia or immune cells. CRH
typically acts through activation of specific receptors that are either
type 1 or types 2 alpha and 2 beta. CRH, or related peptides such as
urocortin, could have proinflammatory effects directly or through
activation of mast cells leading to destruction of the hair root.
Objectives: To investigate the expression of CRH receptors on the
affected skin of patients who developed alopecia areata following acute
emotional stress. Methods: Scalp skin biopsies were obtained from 1
normal volunteer and 3 patients after ring infiltration of the relevant
site with lidocaine. The biopsies were frozen and were later processed
for in situ hybridization for CRH receptors type 1 or types 2 alpha and
2 beta. Sections showing positive results were photographed. Results:
The skin from the normal volunteer showed weak background expression of
all three receptor types. However, skin from the affected sites of all 3
patients studied showed intense expression only on the type 2 beta
receptor around the hair follicles. Conclusion: Acute emotional stress
may precipitate alopecia areata by activation of overexpressed type 2
beta CRH receptors around the hair follicles leading to intense local
inflammation. Copyright (C) 2001 S. Karger AG, Basel."
}