Evaluating the Effect of the Demographic, Trichoscopic and Laboratory Characteristics on The Recurrence of Alopecia Areata
Keywords:
alopecia areata, recurrence, dermoscopy, trichoscopyAbstract
Introduction: Alopecia areata (AA) has diverse disease characteristics and multiple factors may interfere with the prognosis of the disease.
Objectives: In this study, the factors affecting the AA recurrence were evaluated.
Methods: A total of a hundred patients diagnosed with AA between June 2022 and March 2023 were included in this retrospective, cross-sectional study. The patients were divided into two groups according to the presence of outbreaks. Both groups were compared in terms of age, gender, disease duration, number of outbreaks, family history of AA, previous medical treatment history for AA, clinical type, disease severity, presence of accompanying nail findings, and trichoscopic and laboratory characteristics.
Results: Among 100 patients, male dominance was found (N = 69). Most of the patients had patchy disease (90/100), mild disease severity (88/100), and a solitary outbreak (65/100). Male gender, longer disease duration, family history, presence of S2 severity of alopecia tool score, trachyonychia, short vellus hairs in trichoscopic examination, hypothyroidism, and folic acid deficiency were factors for AA outbreaks. Male gender and the presence of a family member with AA in the family were defined as the independent prognostic factors for disease recurrence.
Conclusions: While demographic, laboratory, and clinical findings are factors for AA outbreaks in the follow-up, male gender and family history should be considered independent predictors.
References
Sterkens A, Lambert J, Bervoets A. Alopecia areata: a review on diagnosis, immunological etiopathogenesis and treatment options. Clin Exp Med. 2021;21(2):215-230. DOI:10.1007/s10238-020-00673-w. PMID: 33386567.
Fernández-Domper L, Ballesteros-Redondo M, Vañó-Galván S. Trichoscopy: An Update. Actualización en tricoscopia. Actas Dermosifiliogr. 2023;114(4):327-333. DOI:10.1016/j.ad.2022.12.003.
Ferentinos P, Kalogeropoulou E, Pappa G, et al. Assessing the role of stressful life events in the induction and recurrence of alopecia areata: A case-control study. J Am Acad Dermatol. 2022;87(5):1215-1217. DOI:10.1016/j.jaad.2022.03.036. PMID: 35341888.
Rossi A, Magri F, Michelini S, et al. Recurrence of alopecia areata after covid-19 vaccination: A report of three cases in Italy. J Cosmet Dermatol. 2021;20(12):3753-3757. DOI:10.1111/jocd.14581.
Kutlu Ö, Aktaş H, İmren IG, Metin A. Short-term stress-related increasing cases of alopecia areata during the COVID-19 pandemic. J Dermatolog Treat. 2022;33(2):1177. DOI:10.1080/09546634.2020.1782820.
Rossi A, Magri F, Michelini S, et al. Recurrence of alopecia areata after covid-19 vaccination: A report of three cases in Italy. J Cosmet Dermatol. 2021;20(12):3753-3757. DOI:10.1111/jocd.14581. PMID: 34741583.
Agre K, McCarthy Veach P, Bemmels H, Wiens K, LeRoy BS, Hordinsky M. Familial implications of autoimmune disease: Recurrence risks of alopecia areata and associated conditions in first-degree relatives. J Genet Couns. 2020;29(1):35-43. DOI:10.1002/jgc4.1178. PMID: 31605426.
Olsen EA, Hordinsky MK, Price VH, et al. Alopecia areata investigational assessment guidelines--Part II. National Alopecia Areata Foundation. J Am Acad Dermatol. 2004;51(3):440-447. DOI: 10.1016/j.jaad.2003.09.032. PMID: 15337988.
Marks DH, Penzi LR, Ibler E, et al. The Medical and Psychosocial Associations of Alopecia: Recognizing Hair Loss as More Than a Cosmetic Concern. Am J Clin Dermatol. 2019;20(2):195-200. DOI:10.1007/s40257-018-0405-2. PMID: 30390206.
Mostaghimi A, Gao W, Ray M, et al. Trends in Prevalence and Incidence of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis Among Adults and Children in a US Employer-Sponsored Insured Population. JAMA Dermatol. 2023;159(4):411-418. DOI:10.1001/jamadermatol.2023.0002. PMID: 36857069. PMCID: PMC9979012.
Kavak A, Yeşildal N, Parlak AH, et al. Alopecia areata in Turkey: demographic and clinical features. J Eur Acad Dermatol Venereol. 2008;22(8):977-981. DOI:10.1111/j.1468-3083.2008.02699.x. PMID: 18384559.
Bhardwaj P, Basu D, Podder I, Gharami RC. Clinico-Epidemiological Profile of Childhood Alopecia Areata Along with Dermoscopic Correlation: A Cross-Section, Observational Study. Indian Dermatol Online J. 2021;12(2):250-257. Published 2021 Mar 2. DOI:10.4103/idoj.IDOJ_451_20. PMID: 33959521. PMCID: PMC8088186.
Agre K, McCarthy Veach P, Bemmels H, Wiens K, LeRoy BS, Hordinsky M. Familial implications of autoimmune disease: Recurrence risks of alopecia areata and associated conditions in first-degree relatives. J Genet Couns. 2020;29(1):35-43. DOI:10.1002/jgc4.1178. PMID: 31605426.
Chen Y, Griffiths CEM, Bulfone-Paus S. Exploring Mast Cell-CD8 T Cell Interactions in Inflammatory Skin Diseases. Int J Mol Sci. 2023;24(2):1564. DOI: 10.3390/ijms24021564. PMID: 36675078. PMCID: PMC9861959.
Morsy H, Maher R, Negm D. Correlation between serum IL-17A level and SALT score in patients with alopecia areata before and after NB-UVB therapy. J Cosmet Dermatol. 2018;17(3):533-537. DOI:10.1111/jocd.12664. PMID: 29707896.
King B, Guttman-Yassky E, Peeva E, et al. A phase 2a randomized, placebo-controlled study to evaluate the efficacy and safety of the oral Janus kinase inhibitors ritlecitinib and brepocitinib in alopecia areata: 24-week results. J Am Acad Dermatol. 2021;85(2):379-387. DOI:10.1016/j.jaad.2021.03.050. PMID: 33757798.
Kennedy Crispin M, Ko JM, Craiglow BG, et al. Safety and efficacy of the JAK inhibitor tofacitinib citrate in patients with alopecia areata. JCI Insight. 2016;1(15):e89776. Published 2016 Sep 22. DOI:10.1172/jci.insight.89776. PMID: 27699252. PMCID: PMC5033755.
Spano F, Donovan JC. Alopecia areata: Part 1: pathogenesis, diagnosis, and prognosis. Can Fam Physician. 2015;61(9):751-755. PMID: 26371097. PMCID: PMC4569104.
Gonul M, Cakmak SK, Soylu S, Kilic A, Gul U. Serum vitamin B12, folate, ferritin, and iron levels in Turkish patients with alopecia areata. Indian J Dermatol Venereol Leprol. 2009;75(5):552.DOI:10.4103/0378-6323.55430. PMID: 19736464.
Ertugrul DT, Karadag AS, Takci Z, et al. Serum holotranscobalamine, vitamin B12, folic acid and homocysteine levels in alopecia areata patients. Cutan Ocul Toxicol. 2013;32(1):1-3. DOI: 10.3109/15569527.2012.683499. PMID: 22591107.
Goksin S. Retrospective evaluation of clinical profile and comorbidities in patients with alopecia areata. North Clin Istanb. 2022;9(5):451-458. DOI: 10.14744/nci.2022.78790. PMID: 36447582. PMCID: PMC9677058.
Published
Issue
Section
License
Copyright (c) 2023 Didem Kazan
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Dermatology Practical & Conceptual applies a Creative Commons Attribution License (CCAL) to all works we publish (http://creativecommons.org/licenses/by-nc/4.0/). Authors retain the copyright for their published work.
How to Cite
Share
