Patient perspectives of the cumulative life course impairment of alopecia areata

Burns, Lindsay H.; Flanagan, Kelly; Ellison, Abby; Mesinkovska, Natasha Atanaskova; Senna, Maryanne M.

doi:10.1111/ced.14597

Cited by 7 publications

(23 citation statements)

References 6 publications

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“…Patients with AA struggled to develop new and to maintain existing romantic relationships 36 . Specifically, they were not comfortable discussing their diagnosis with new partners and feared being perceived as unattractive 18 .…”

Section: Resultsmentioning

confidence: 99%

“…This led to reduced QoL, mental wellbeing and school attendance/performance. Children reported embarrassment, staying home from school at least once, performing poorly due to distraction and distress, 18,61 limiting their participation in scholarly and parascholar activities and formation of friendships and self‐esteem 36 . It is therefore common for these patients to struggle with a restricted lifestyle, failing or discontinuing school, and to practice avoidance of sports and social events as they get older 18,36 …”

Section: Resultsmentioning

confidence: 99%

“…Boys and those with patchy AA were at a higher risk of bullying, absenteeism and/or poor performance 61 . Of note, restricted lifestyle during childhood was associated with life‐long repercussions 18,36 . AA also interfered with individuals’ career choices and ability to obtain promotions 10,18 .…”

Section: Discussionmentioning

confidence: 99%

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The burden of alopecia areata: A scoping review focusing on quality of life, mental health and work productivity

Muntyanu

Gabrielli

Donovan

et al. 2023

Acad Dermatol Venereol

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Alopecia areata (AA) is a common inflammatory autoimmune disease of the hair which can have a significant negative impact on quality of life (QoL), mental health and productivity. The aim of this scoping review is to elucidate the burden of AA focusing on these three realms. Inclusion criteria included all original manuscripts with no restriction on study type or statistical method written in English (or having an English abstract). For QoL 40 articles were included, 85 for psychiatric comorbidities, and 9 for work/school absenteeism/presenteeism mostly consisting of cross‐sectional and observational cohort studies. QoL impairment was detected in over 75% of patients and up to one‐third reported extremely severe QoL impairments. Specific QoL dimensions with the greatest impact were embarrassment, social functioning, as well as shopping and/or housework. Cross‐sectional studies assessing the psychological burden of adult patients with AA found that the presence of signs of anxiety and/or depression ranged from 30% to 68% and affected all age groups. Rates of work absenteeism and unemployment were significantly higher in AA patients compared to healthy controls. Up to 62% reported making major life decisions including relationships, education and career based on their AA. Additionally, the extensive camouflage techniques and time lost from work led to a strong financial burden for patients and the numerous physician visits added to the healthcare costs. The overall impact of AA stretches much further than simply being an aesthetic concern and can negatively impact every part of an individual's life. An individualized approach and effective treatments will help reduce the psychosocial consequences and distress and return patients to their normal state of health.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The burden of alopecia areata: A scoping review focusing on quality of life, mental health and work productivity

Muntyanu

Gabrielli

Donovan

et al. 2023

Acad Dermatol Venereol

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“…Alopecia areata resulting in complete loss of scalp or total body hair is referred to as alopecia totalis (AT) or alopecia universalis (AU), respectively. Although AA is generally asymptomatic, hair loss due to AA results in significant effects on quality of life . Alopecia areata has also been linked to increased risk of mood disorders including anxiety and depression …”

Section: Introductionmentioning

confidence: 99%

“…Although AA is generally asymptomatic, hair loss due to AA results in significant effects on quality of life. [3][4][5][6] Alopecia areata has also been linked to increased risk of mood disorders including anxiety and depression. 7,8 Information on overall prevalence of AA and its subtypes in the US is limited, even more so as it relates to disease burden among demographic subgroups.…”

mentioning

confidence: 99%

Overall and Racial and Ethnic Subgroup Prevalences of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis

Mastacouris

Strunk

et al. 2023

JAMA Dermatol

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ImportancePrevalences of alopecia areata (AA), alopecia totalis (AT), and alopecia universalis (AU) are poorly established.ObjectiveTo estimate overall and subgroup prevalences of AA and its subtypes.Design, Setting, and ParticipantsThis cross-sectional study using electronic records comprising the Explorys database (Watson Health, IBM Corporation) included children, adolescents, and adults seeking healthcare across the 4 census regions in the US between January 1, 2019, and December 31, 2019. The statistical analysis was conducted between July 21, 2022, and December 22, 2022.Main Outcomes and MeasuresPrevalent cases of AA, AT, and AU.ResultsOf the 1 093 176 patients who met inclusion criteria, 1812 had at least 1 code for AA, 1216 female (67%) and 596 male (33%) patients. Overall age-and-sex standardized prevalences among adults and among children and adolescents were observed to be 0.18% and 0.10%, respectively. The age-standardized prevalence ratio in women to men was 1.32. Standardized prevalence was highest in those aged 30 to 39 (297 per 100 000; 95% CI, 263-335) and 40 to 49 (270 per 100 000; 95% CI, 240-303) years. The highest standardized prevalence was observed among Asian patients (414 per 100 000; 95% CI, 306-548), followed by patients reporting another race or multiple races (314 per 100 000; 95% CI, 266-368), Black (226 per 100 000; 95% CI, 199-255), and Hispanic/Latino (212 per 100 000; 95% CI, 129-328) patients. White patients had the lowest standardized prevalence (168 per 100 000; 95% CI, 157-179) among racial and ethnic subgroups. Relative to White patients, standardized prevalence ratios for Asian, Black, and Hispanic/Latino patients were 2.47 (95% CI, 2.17-2.81), 1.35 (95% CI, 1.26-1.44), and 1.26 (95% CI, 1.03-1.55), respectively. Cases of AT and AU comprised approximately 9% of patients diagnosed with AA.Conclusions and RelevanceThe findings of this cross-sectional study suggest that there is a significant burden of AA, AT, and AU in the US in which people of color, particularly Asian Americans, appear to be disproportionately affected.

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Assessing the burden of patients with psoriasis through the concept of cumulative life course impairment: A narrative literature review

Crochard

Gherardi

Kollen

et al. 2023

JEADV Clinical Practice

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Psoriasis can affect diverse facets of patients' lives over time and may lead to irreversible cumulative life course impairment (CLCI). The CLCI concept initially described in 2010 in the context of psoriasis encompasses the intricate interaction between physical, psychological, social and economic burden and is influenced by several factors such as coping mechanisms, personality and external factors. CLCI assessment is conducted to characterise and ultimately mitigate or prevent the patient's burden over the life course. This review aims to give a comprehensive overview of the development and use of the CLCI concept in psoriasis since its inception. A narrative literature review was conducted from 2010 to 2022 and included 19 publications. As original studies on CLCI are scarce, this review primarily relied on case studies and those without longitudinal assessment. The core components of CLCI burden identified in patients' narratives include physical impairment, psychological impairment, stigma, socioeconomic burden and modulating factors. Modulating factors are crucial to mitigate the burden but are not equally explored. The burden associated with psoriasis stands across all dimensions covered by CLCI, thus confirming its suitability in clinical management and future studies. A better understanding of CLCI can support physicians and researchers in improving patients' lives and raising awareness on the necessity to develop early, efficient and patient‐centric interventions. The practical and systematic adoption of CLCI yet relies on the development and psychometric validation of a questionnaire that measures it.

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Patient perspectives of the cumulative life course impairment of alopecia areata

Cited by 7 publications

References 6 publications

The burden of alopecia areata: A scoping review focusing on quality of life, mental health and work productivity

The burden of alopecia areata: A scoping review focusing on quality of life, mental health and work productivity

Overall and Racial and Ethnic Subgroup Prevalences of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis

Assessing the burden of patients with psoriasis through the concept of cumulative life course impairment: A narrative literature review

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