Alopecia areata: a long‐term follow‐up study of 104 patients

Abstract

Background Alopecia areata (AA) is a common autoimmune disease that considerably affects the quality of life. Although several studies have investigated the epidemiology, clinical characteristics and treatment of AA, limited recent data are available regarding its long‐term course. Objectives To evaluate the long‐term course of AA in different age groups. Methods A retrospective evaluation of patients who were newly diagnosed with AA from 2008 to 2011 and had at least 7 years of follow‐up. Data regarding the initial episode, treatment given, disease‐free interval and relapses were analysed. Results A total of 104 cases were analysed: 31 childhood‐onset, 63 adult‐onset and 10 late‐onset. At first episode, 88.5% of patients had mild, 3.8% moderate and 7.7% severe AA. Full or significant re‐growth was observed in 74%, 94% and 100% of childhood‐onset, adult‐onset and late‐onset AA patients, respectively. There was no re‐growth in 13%, 3% and 0% of childhood‐onset, adult‐onset and late‐onset patients, respectively. The duration of the initial episode and the disease‐free interval negatively correlated with age. Systemic steroids were the most effective treatment for the primary episode. The frequency of relapses was high overall (52%, 44% and 30% in childhood‐onset, adult‐onset and late‐onset, respectively), but significantly declined over time with a majority (79%) occurring within the first 4 years. The disease‐free interval and relapse rate were not correlated with gender, disease severity at onset or treatment given. Conclusions The prevalence of severe disease, duration of an initial episode and the rate of relapses decreased with an older age at onset. In addition, the outcome and the disease‐free interval improved with age at onset. The frequency of relapses declined over time and most appear early on. The current treatment modalities do not seem to influence the long‐term outcome.

Prognostic Factors in Mexican Patients with Patchy and Other Types of Alopecia Areata

“…We found that disease onset at an early age and AA types with extensive hair loss were more prevalent in patients with progression than in no progression group, with similar results reported previously [10, 11]. Lyakhovitsky et al [10] found that patients with disease onset at an early age had a higher prevalence of disease severity. However, some authors have not found these associations [9] and remain controversial.…”

Alopecia areata as an immune‐related adverse event of immune checkpoint inhibitors: A review

“…20 Instead, younger age of onset and severe hair loss on first consultation are important prognostic factors. 6,7 The median age of our patients is 62 (SD = 15;…”

“…4,5 Classic AA is difficult to treat with high rates of relapse and will progress into permanent hair loss in a subset of patients. 6,7 It is unclear if ICI-induced AA follows a similar course. With the expanding use of ICI to treat a wide range of malignancies, the incidence of irAEs including AA will invariably increase.…”

Boehmite enhances hair follicle growth via stimulation of dermal papilla cells by upregulating β‐catenin signalling

“…In the past, alopecia only occurred in middle-aged people, but, recently, it has been frequently occurring in individuals in their 20 and 30 seconds. [16,17] The most common type of male hair loss is androgenetic alopecia, which occurs gradually over time and most pronouncedly begins at the crown of the head and proceeds towards the forehead.…”

“…The types and causes of hair loss studied so far vary; several studies presumed that the causes of alopecia are excessive sebum production due to endocrine disorders (eg hormone imbalance), circulatory disorders (eg autonomic nervous system and blood circulation disorders), hair follicle malnutrition, allergy, bacterial infection, genetic factors, mental stress, environmental factors (eg air or food pollution) and ageing. In the past, alopecia only occurred in middle‐aged people, but, recently, it has been frequently occurring in individuals in their 20 and 30 seconds …”