Comorbidities in pediatric alopecia areata

Abstract

Background Comorbidities are associated with higher health care costs, complex management, and poorer health outcomes. Identification and treatment of comorbid conditions in paediatric alopecia areata (AA) patients could provide an opportunity to improve health outcomes. Objectives To determine the prevalence of comorbidities among paediatric patients with AA using a large de-identified aggregated patient database. Methods This is a cross-sectional study using aggregated health record data through April 1, 2019. Patients ≤18 years of age, with alopecia areata (n = 3510) and without alopecia areata (n = 8 310 710) were identified. The primary outcome was the prevalence of comorbidities among AA patients. Results Of the 8 314 220 paediatric patients, 3510 (1570 males and 1940 females) had a diagnosis of alopecia areata. The most common comorbidities included atopic dermatitis (17.4% vs.

Current controversies in trichology: a European expert consensus statement

“…Whether alopecia areata is an autoimmune disease still remains controversial 35 but many studies have shown that severe cases are associated with a systemic activation of the immune system 36–39 . While topic or local therapies may cause hair regrowth, they are unlikely to target the cause of the disease; the use of systemic therapy is recommended for those patients.…”

“…Systemic therapy is advisable for moderate-to-severe alopecia areata due to its association with systemic activation of the immune system Whether alopecia areata is an autoimmune disease still remains controversial 35 but many studies have shown that severe cases are associated with a systemic activation of the immune system. [36][37][38][39] While topic or local therapies may cause hair regrowth, they are unlikely to target the cause of the disease; the use of systemic therapy is recommended for those patients. The specific therapy (i.e.…”

Systemic aspects of alopecia areata Comment to the article by Lai and Sinclair

“…Alopecia areata was associated with significantly increased prevalence of atopic dermatitis (17.4% vs. 2.2% in the control group) anaemia (7.7% vs. 2.4%), obesity (5.7% vs. 1.1%), vitamin D deficiency (5.1% vs. 0.4%), hypothyroidism (2.6% vs. 0.2%), vitiligo (1.4% vs. 0.04%), psoriasis (1.4% vs. 0.07%), hyperlipidaemia (1.4% vs. 0.2%) and depression (2.6% vs. 0.6%). 8 Studies on the gut microbiome in 30 patients with alopecia areata showed significant changes, with an enriched presence of Holdemania filiformis, Erysipelotrichacea, Lachnospiraceae, Parabacteroides johnsonii, Clostridiales vadin BB60 group, Bacteroides eggerthii and Parabacteroides distasonis. 9 Finally, alopecia areata may be associated with a profound psychosocial burden, a decreased quality of life, anxiety, depression, alexithymia and impaired sleep quality 10 Thus, we hypothesize that alopecia areata is a disease with significant systemic impact (or a systemic disease per se) and evaluation of treatment efficacy should include general health parameters in addition to hair regrowth.…”

Childhood atopic dermatitis as a precursor for developing attention deficit/hyperactivity disorder

“…lichenification, oozing/weeping, erosions, xerosis, plaques, papules, follicular accentuation, lichenoid papules, prurigo nodules). 2,3 Big data reveal increase in AD burden with several comorbidities, both cutaneous 5 and systemic ones 6,7 AD shows itself with dysfunctioning immune and non-immune skin-barrier components. AD patients have a low compliance with long-term therapies and that may be due to the underrecognized psychiatric burden 8 occasionally relapsing for different stressful conditions such as COVID-19 outbreak.…”