Multivariate analysis of prognostic factors in patients with rapidly progressive alopecia areata

Uchiyama, M; Egusa, Chizu; Hobo, Ayako; Irisawa, Ryokichi; Yamazaki, Masashi; Tsuboi, Ryoji

doi:10.1016/j.jaad.2012.06.006

Cited by 29 publications

(34 citation statements)

References 20 publications

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“…Late-onset AA is characterized by a marked female predominance, and disease severity is inversely proportional to age [17, 18], which is supported by the clinical consensus that young patients are often afflicted with a rapid disease progression, more extensive involvement, and a worse prognosis [53]. The association between AA and atopy among the pediatric population is controversial considering that an early disease onset often signifies a worse prognosis, while an increased age of onset is associated with a more mild disease course [16].…”

Section: Discussionmentioning

confidence: 99%

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

Sung

Choi

Juhász

et al. 2019

Skin Appendage Disord

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Background: While alopecia areata (AA) has been associated with atopy, the immunological relationship is unclear, with the association of specific atopic and systemic respiratory diseases not established. The relationship between T-helper (Th)1-mediated AA and Th2-mediated atopy challenges the conventional Th1/Th2 paradigm of autoimmune disease categorization. Objectives: To determine the association between AA and atopic respiratory diseases in adults and children, and respiratory diseases in general. Method: All primary literature, excluding case reports, were identified within PubMed/MEDLINE, CINAHL, and Web of Science in May 2018 using the following search terms: “(alopecia OR hair loss) AND (respiratory OR pulmonary OR lungs OR asthma OR rhinitis OR bronchitis OR COPD OR atopy OR atopic).” Information from 32 articles meeting the inclusion and exclusion criteria was reviewed. Results: Among the 32 articles identified for inclusion, the prevalence of AA was more strongly associated with allergic rhinitis compared to asthma among pediatric and adult populations. While a significant association was identified between AA, allergic rhinitis, and a late age of onset, the association of AA and asthma remains controversial despite asthma’s prevalence among AA patients. No significant difference was identified with regard to the association of AA and non-atopic respiratory diseases between adult and pediatric patients. Conclusions: Adult and pediatric patients with AA warrant further workup for atopic respiratory diseases such as allergic rhinitis. AA may have an underlying Th2-mediated immunological component, which supports its association with atopic respiratory diseases and provides a new avenue for targeted therapies in select cases.

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Section: Discussionmentioning

confidence: 99%

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

Sung

Choi

Juhász

et al. 2019

Skin Appendage Disord

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“…The course of AA is unpredictable; in eachand the definition of late-onset AA varies among authors. Two recent studies suggested a slight female predominance, a milder disease course, and a better prognosis with advancing age [6][7][8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Late-Onset Alopecia Areata: A Retrospective Cohort Study

et al. 2017

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Background: Alopecia areata is an immune-mediated disease presenting with sudden onset of nonscarring hair loss. Onset is more common earlier in life, and little is known regarding late-onset alopecia areata. Objectives: To describe the epidemiology, clinical patterns, disease course, and outcome of late-onset alopecia areata in Israeli patients referred to a tertiary medical center. Materials and Methods: This retrospective cohort study considered patients whose disease onset occurred at age ≥50 years. Patients were recruited from among all alopecia areata patients visiting a tertiary center between January 2009 and April 2015. Results: Of the 29 people included, 25 (86.2%) were female (female-to-male ratio, 6.2:1). There was a family history of alopecia areata in 17.2%, thyroid disease in 31%, atopic background in 6.9%, and 17/29 (58.6%) reported a significant stressful event. The most common disease pattern was patchy, and disease was mild in the majority of participants. Complete hair regrowth was observed in 82.8% of participants, and 37.9% relapsed. Conclusion: Late-onset alopecia areata is characterized by marked female predominance, less extensive disease, and a high incidence of complete hair regrowth.

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“…Some studies [28,29,30,31] have suggested that disease duration >2 years, atopy history, coexistence of autoimmune disease(s), low weight in women [16] or the AA universalis pattern are poor prognostic factors for hair regrowth in AA. Hammerschmidt and Mulinari-Brenner [20] recently found that for patients receiving MTX, multifocal AA and disease duration <5 years were associated with a better response to treatment.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Methotrexate Combined with Low- to Moderate-Dose Corticosteroids for Severe Alopecia Areata

Anuset¹,

Perceau²,

Bernard³

et al. 2016

Dermatology

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Background: In severe alopecia areata (AA), spontaneous recovery is unlikely, and treatment is not standardized. Objective: To evaluate the efficacy and safety of methotrexate (MTX) used alone or combined with low- to moderate-dose oral corticosteroids (OC) for treating severe AA (totalis, universalis and severe multifocal). Methods: Retrospective monocentric study of all consecutive patients receiving this treatment between 2006 and 2012. Efficacy was defined as achieving a total regrowth of terminal hair. Results: 26 patients were included (17 with AA universalis or totalis and 9 with severe multifocal AA). Total regrowth was noted in 15/26 patients. After 3 months of treatment, hair regrowth >80% was associated with further complete regrowth, and hair regrowth <30% was associated with later treatment failure (p = 0.0014). When treatment was tapered, 11/15 patients with initial complete efficacy experienced AA relapse. Conclusion: MTX combined with low- to moderate-dose OC may be an efficient and well-tolerated treatment for severe AA. However, long-term maintenance treatment is usually required.

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Multivariate analysis of prognostic factors in patients with rapidly progressive alopecia areata

Cited by 29 publications

References 20 publications

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

Late-Onset Alopecia Areata: A Retrospective Cohort Study

Efficacy and Safety of Methotrexate Combined with Low- to Moderate-Dose Corticosteroids for Severe Alopecia Areata

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