Abstract: 【Abstract】 Alopecia areata is a T cell-mediated autoimmune non-scarring hair loss disorder. Its core pathogenesis involves the collapse of immune privilege in hair follicles, which subsequently triggers CD8? T cell-mediated autoimmune responses and activates multiple inflammatory pathways, including Th1, Th2, Th17, and Treg pathways. Genetic susceptibility also contributes to disease development. Pediatric alopecia areata is highly heterogeneous. Earlier age at onset, particularly before 6 years of age, is associated with greater disease severity and higher recurrence rates, leading to a more substantial impact on the quality of life of affected children and their families. Pediatric alopecia areata should be differentiated from congenital and other acquired hair loss disorders in children. Currently, the management of pediatric alopecia areata faces challenges such as age restrictions for certain treatments and limited high-level evidence-based medical data. Therefore, stratified management based on age, disease stage, and severity is recommended. Based on the latest Chinese and international clinical guidelines and research evidence, as well as key clinical questions identified using the Delphi method, an expert panel was organized to develop this consensus after systematic evaluation and discussion. This consensus provides recommendations covering clinical classification, diagnostic pathways, assessment tools, and treatment strategies, aiming to promote the standardized diagnosis and treatment of pediatric alopecia areata in China and provide guidance for clinical practice.

Key words: Alopecia areata, Children, Diagnosis, Therapy, Expert consensus