Incident alopecia areata and vitiligo in adult women with atopic dermatitis: Nurses’ Health Study 2

Drucker, Aaron M.; Thompson, Jordan M.; Li, Wenqing; Cho, Eunyoung; Li, Tricia; Guttman‐Yassky, Emma; Qureshi, Abrar A.

doi:10.1111/all.13128

Cited by 39 publications

(27 citation statements)

References 16 publications

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“…In addition, we now have sub‐populations of refined confirmed AD cases within the cohort. These findings provide some reassurance about the validity of our previous analyses on AD in this cohort and are encouraging for future work . Future analyses in NHS2 can explore associations of AD using multiple case definitions, adding to the robustness of their findings.…”

Section: Discussionsupporting

confidence: 61%

“…Our research group has published AD‐related analyses using data from Nurses’ Health Study 2 (NHS2), an ongoing cohort of US female nurses, which relies on self‐report of ever receiving a clinician diagnosis of AD for its case definition . Participants are also asked what year they were diagnosed.…”

Section: Introductionmentioning

confidence: 99%

“…13 Our research group has published AD-related analyses using data from Nurses' Health Study 2 (NHS2), an ongoing cohort of US female nurses, which relies on self-report of ever receiving a clinician diagnosis of AD for its case definition. [14][15][16][17][18] Participants are also asked what year they were diagnosed. In this study, we aimed to assess the accuracy of self-report of AD among NHS2 participants using a validated questionnaire.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis validation and clinical characterization of atopic dermatitis in Nurses’ Health Study 2

Drucker

Cho

et al. 2019

Acad Dermatol Venereol

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Background Epidemiologic studies of atopic dermatitis (AD) are often limited by case definitions that have not been validated. Objective In this study, we assessed the accuracy of self‐report of AD in a large cohort of US female nurses, the Nurses’ Health Study 2 (NHS2). We also provide clinical characteristics of AD in the cohort. Methods We sent an electronic questionnaire to NHS2 participants who previously reported ever having a diagnosis of AD. This questionnaire was designed to confirm cases of AD using previously validated algorithms with >85% specificity. We assessed the association of AD with asthma, comparing the results when different definitions of AD were applied. We also inquired about various aspects of participants’ AD. Results Responses were received from 2509 of 5126 (49%) nurses who were sent the questionnaire, with an average age of 62. Most participants (1996/2509, 80%) reiterated their previously reported clinician diagnosis of AD. Application of the two diagnostic algorithms yielded confirmation of 1538 and 1293 prevalent cases, respectively. The association of AD with asthma was stronger when more stringent AD case definitions were applied. Participants generally reported mild disease (92% with ≤10% maximal body surface area involved) and a high proportion (57%) reported adult‐onset disease. Conclusions Self‐report of AD diagnosis has good reliability, and future analyses will be strengthened by our ability to conduct sensitivity analyses with refined confirmed AD subgroups.

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Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosis validation and clinical characterization of atopic dermatitis in Nurses’ Health Study 2

Drucker

Cho

et al. 2019

Acad Dermatol Venereol

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“…These reports could reflect seasonal changes in allergen exposure and/or viral load. Comorbid atopic diseases; rhinitis, asthma, dermatitis and food allergy . Atopy increases the risk of developing AA . Early‐onset AA, or alopecia totalis (AT) and alopecia universalis (AU), has an increased prevalence concurrent with atopy .…”

Section: Premisementioning

confidence: 99%

Allergy promotes alopecia areata in a subset of patients

Zhang

McElwee

2019

Experimental Dermatology

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In this commentary, we focus on allergy as a facilitating factor in the pathogenesis of alopecia areata (AA). From previous studies on AA, it is well known that subsets of patients can have one or more of; seasonal relapse, comorbid atopic rhinitis, asthma and dermatitis, lesion infiltrating eosinophils and plasma cells, high levels of total IgE, specific IgE for house dust mites (HDMs), and/or disrupted skin barrier function by the evaluation of filaggrin. Allergy and AA share a similar genetic background; both contributing to an immune reaction imbalance. Furthermore, adjunctive treatment with antihistamines, or desensitization for HDM, can reduce the severity of alopecia in atopic AA patients. Therefore, allergies may contribute to the onset and relapse of AA. Identification of an allergic or atopic immune component in AA patient subsets may indicate adjunctive treatment intervention measures against allergies should be taken which may improve the success of conventional AA treatment.

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“…Patients will report itch and ongoing inflammation when lesions newly develop or expand, even if the severity of pruritus does not match that reported in atopic dermatitis . Interestingly, patients with vitiligo are more likely to develop vitiligo and vice versa . Pruritus and/or a particular lesional distribution suggest a distinct pathomechanism in this subgroup.…”

Section: Intracellular Metabolismmentioning

confidence: 99%

The convergence theory for vitiligo: A reappraisal

Kundu

Mhlaba

Rangel

et al. 2018

Experimental Dermatology

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Vitiligo is characterized by progressive loss of skin pigmentation. The search for aetiologic factors has led to the biochemical, the neurologic and the autoimmune theory. The convergence theory was then proposed several years ago to incorporate existing theories of vitiligo development into a single overview of vitiligo aetiology. The viewpoint that vitiligo is not caused only by predisposing mutations, or only by melanocytes responding to chemical/radiation exposure, or only by hyperreactive T cells, but rather results from a combination of aetiologic factors that impact melanocyte viability, has certainly stood the test of time. New findings have since informed the description of progressive depigmentation. Understanding the relative importance of such aetiologic factors combined with a careful selection of the most targetable pathways will continue to drive the next phase in vitiligo research: the development of effective therapeutics. In that arena, it is likewise important to acknowledge that pathways affected in some patients may not be altered in others. Taken together, the convergence theory continues to provide a comprehensive viewpoint of vitiligo aetiology. The theory serves to intertwine aetiologic pathways and will help to define pathways amenable to disease intervention in individual patients.

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Incident alopecia areata and vitiligo in adult women with atopic dermatitis: Nurses’ Health Study 2

Cited by 39 publications

References 16 publications

Diagnosis validation and clinical characterization of atopic dermatitis in Nurses’ Health Study 2

Diagnosis validation and clinical characterization of atopic dermatitis in Nurses’ Health Study 2

Allergy promotes alopecia areata in a subset of patients

The convergence theory for vitiligo: A reappraisal

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