Title : An alopecia unlike any other: Satoyoshi syndrome
Abstract:
Introduction: Satoyoshi syndrome is a rare multisystem disorder with a presumed autoimmune etiology. It is characterized by the triad of alopecia, painful muscle spasms, and chronic diarrhea, often associated with the presence of anti-nuclear antibodies.
Objective: To report a case of Satoyoshi syndrome revealed by alopecia areata in a 15-year-old girl.
Observation: The patient presented with a six-year history of chronic diarrhea and extensive alopecia ophiasis evolving over two years, accompanied by recurrent muscle cramps in the lower limbs. Physical examination revealed growth retardation (height: 1.42 m; weight: 40 kg). Laboratory tests showed positive anti-nuclear antibodies. Trichoscopic examination demonstrated regularly distributed yellow dots with peripheral vellus hairs. The diagnosis of Satoyoshi syndrome was established based on the combination of alopecia, diarrhea, muscle cramps, and ANA positivity. Treatment with methotrexate combined with triamcinolone led to significant clinical improvement.
Discussion: Satoyoshi syndrome, first described by Satoyoshi in 1967, is considered an autoimmune condition characterized by severe alopecia, intermittent muscle spasms, and gastrointestinal disturbances. The presence of autoantibodies and the favorable response to immunosuppressive therapy support its autoimmune nature. Diagnosis is based on the association of alopecia with at least two other manifestations such as muscle cramps, diarrhea, or immunological abnormalities. Early diagnosis and treatment with corticosteroids or immunosuppressants are essential to improve prognosis.
Conclusion: Satoyoshi syndrome should be considered in patients presenting with severe alopecia areata associated with systemic symptoms such as diarrhea and muscle cramps. Early recognition and appropriate immunosuppressive therapy can lead to favorable clinical outcomes.
