Profile of Alopecia Areata in Northern India

Abstract

Background. Epidemiologic studies of alopecia areata (AA) are available from USA, Japan, and European countries, but there is a paucity of literature on AA from Asian countries, especially from the Indian subcontinent. Methods. In a prospective, hospital‐based study lasting for a decade (1983–1992), the epidemiology of AA was studied, including associated diseases and risk factors for development of severe AA. Simultaneously a similar study was carried out in age‐ and sex‐matched controls. Results. Eight hundred and eight patients (532 men, 276 women) and 572 age‐ and sex‐matched controls (370 men, 202 men) were studied. The incidence of AA was 0.7% of new dermatology outpatients. The majority of patients (712, 88%) were below 40 years of age, including 196 children < 16 years of age (24%). Almost half (46%) of the women patients had onset of AA in childhood, compared to only 19% in men (P < 0.001). Alopecia was total, universal, or extensive in 154 patients (19%). An onset in the first two decades was more often associated with severe alopecia (P < 0.001), especially in men (P < 0.01). Alopecia areata was recorded in family members of 70 patients (9%), being more frequent in the severe forms of AA (16%). Evidence of atopy was recorded in a total of 146 instances (18%). The frequency of atopy was the same in circumscribed alopecia (18.1%) and severe alopecia (18.2%). Nail changes were found in 162 patients (20%) and were more frequent in 76 (47%) with the severe form of AA (P < 0.001). On 39 occasions (5%), autoimmune‐related diseases were detected: vitiligo in 15 (1.8%), thyroid disorders in 8 (1%), lichen planus in 6 (0.7%), collagen vascular diseases in 5 (0.6%), diabetes mellitus in 4 patients (0.4%), and pemphigus foliaceus in 1 (0.1%) patient. Patients with family members having vitiligo (recorded in 5.9% of patients), were more frequently affected with severe alopecia (P < 0.001). Conclusions. Alopecia areata in North Indians showed a preponderance in men (M:F = 2:1) and the majority of persons with disease (88%) were below 40 years of age. Onset in childhood was more frequent in girls or women, but the incidence of severe alopecia was higher in boys or men with onset at an earlier age. Diseases associated with autoimmunity were seen in only 5% of patients. Atopy was found to be associated in 18% of patients, but its reported association with younger age of onset and severe alopecia was not confirmed. Presence of vitiligo in family members and onset before 20 years of age, especially in boys or men, were found to be risk factors for severe alopecia. Int J Dermatol 1996; 35:22–27

Epidemiological and clinical characteristics of alopecia areata: an observational study from South India

“…Studies from different parts of the world including a previous study from India reported similar findings. 4 Only 13.2% had onset after 40 years of age; Sharma et al had reported 8.8% whereas western literature have reported 19 to 30%. 4,9 In our study an early childhood onset was exclusively noticed in boys though female preponderance was noted in another study from India.…”

“…4 Only 13.2% had onset after 40 years of age; Sharma et al had reported 8.8% whereas western literature have reported 19 to 30%. 4,9 In our study an early childhood onset was exclusively noticed in boys though female preponderance was noted in another study from India. 4 The duration of AA in our study varied from less than 4 weeks to more than 3 years.…”

“…Another Indian study have reported 0.7% incidence. 4 Past studies have reported an equal gender incidence in AA. 7 A male preponderance was reported in a study from India.…”

“…7 A male preponderance was reported in a study from India. 4 A study from Singapore reported slight female preponderance. 5 Our study showed an almost equal gender distribution with 53.7% males and 47% females affected.…”

“…2 Studies from different parts of the world helped to understand AA better. [3][4][5] Our study aims to find the clinical and demographic factors of people with AA from northern part of Kerala state, South were collected from the subjects. Further, any preceding causes known to have related to AA, associated autoimmune problems or any other illnesses in these subjects were probed in detail.…”