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Alopecia areata: a long term follow-up study of 191 patients.
J Am Acad Dermatol. 2006 Sep; 55(3):438-41.JA

Abstract

BACKGROUND

The prognosis of alopecia areata (AA) is difficult to predict. Few studies report long-term follow-up of AA patients.

OBJECTIVE

The purpose of this study is to better assess the long-term evolution of AA and the possible relationship between disease severity and treatment response with long-term prognosis.

METHODS

One hundred ninety-one patients with AA who presented with a new diagnosis of AA between 1983 and 1990 were subsequently contacted by phone. Patients were queried regarding current disease status, treatments, and disease course.

RESULTS

Severity of AA at first consultation ranged from mild (128 patients) to severe (63 patients). Fifty-five of 191 patients were affected by concomitant autoimmune or related inflammatory disease. Sixty-six of 191 patients were presently disease free (follow-up duration, 15-22 years; mean 17.74 years). These include 41 of 60 patients with S1 disease (68.3%), 22 of 68 patients with S2 disease (32.3%), 1 of 11 patients with S3 disease (9%), 1 of 14 patients with S4 disease (7.1%), and 1 of 11 patients with alopecia totalis (AT) (9.1%). Sixty-nine of 191 patients (36-1%) were presently affected by AT or alopecia universalis. There was a statistically significant tendency of severe patterns of AA to worsen over time. In children, 18 of 39 (13 with < or =S2 disease and 5 with > or =S3 disease) with AA had developed AT or alopecia universalis at long-term follow-up. In children, however, this trend was not statistically significant. Patients with severe AA who responded to topical immunotherapy seem to have a better prognosis than nonresponders.

LIMITATIONS

Follow-up was only performed by phone.

CONCLUSIONS

Severity of AA at time of first consultation is an important prognostic factor. Response to therapy (topical immunotherapy) may be associated with better prognosis. In children, the prognosis is worse; our study found that AA worsens over time.

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Authors+Show Affiliations

Tosti A
Department of Dermatology, University of Bologna, Italy. tosti@med.unibo.it
Bellavista S
No affiliation info available
Iorizzo M
No affiliation info available

MeSH

Administration, TopicalAdolescentAdultAgedAlopecia AreataChildChild, PreschoolDisease ProgressionFemaleFicusinFollow-Up StudiesHumansImmunotherapyInterviews as TopicMaleMiddle AgedPhotosensitizing AgentsPrognosisRetrospective StudiesSeverity of Illness IndexSteroidsUltraviolet Therapy

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16908349

Citation

Tosti, Antonella, et al. "Alopecia Areata: a Long Term Follow-up Study of 191 Patients." Journal of the American Academy of Dermatology, vol. 55, no. 3, 2006, pp. 438-41.
Tosti A, Bellavista S, Iorizzo M. Alopecia areata: a long term follow-up study of 191 patients. J Am Acad Dermatol. 2006;55(3):438-41.
Tosti, A., Bellavista, S., & Iorizzo, M. (2006). Alopecia areata: a long term follow-up study of 191 patients. Journal of the American Academy of Dermatology, 55(3), 438-41.
Tosti A, Bellavista S, Iorizzo M. Alopecia Areata: a Long Term Follow-up Study of 191 Patients. J Am Acad Dermatol. 2006;55(3):438-41. PubMed PMID: 16908349.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alopecia areata: a long term follow-up study of 191 patients. AU - Tosti,Antonella, AU - Bellavista,Sara, AU - Iorizzo,Matilde, Y1 - 2006/06/27/ PY - 2005/11/14/received PY - 2006/05/05/revised PY - 2006/05/05/accepted PY - 2006/8/16/pubmed PY - 2006/9/13/medline PY - 2006/8/16/entrez SP - 438 EP - 41 JF - Journal of the American Academy of Dermatology JO - J Am Acad Dermatol VL - 55 IS - 3 N2 - BACKGROUND: The prognosis of alopecia areata (AA) is difficult to predict. Few studies report long-term follow-up of AA patients. OBJECTIVE: The purpose of this study is to better assess the long-term evolution of AA and the possible relationship between disease severity and treatment response with long-term prognosis. METHODS: One hundred ninety-one patients with AA who presented with a new diagnosis of AA between 1983 and 1990 were subsequently contacted by phone. Patients were queried regarding current disease status, treatments, and disease course. RESULTS: Severity of AA at first consultation ranged from mild (128 patients) to severe (63 patients). Fifty-five of 191 patients were affected by concomitant autoimmune or related inflammatory disease. Sixty-six of 191 patients were presently disease free (follow-up duration, 15-22 years; mean 17.74 years). These include 41 of 60 patients with S1 disease (68.3%), 22 of 68 patients with S2 disease (32.3%), 1 of 11 patients with S3 disease (9%), 1 of 14 patients with S4 disease (7.1%), and 1 of 11 patients with alopecia totalis (AT) (9.1%). Sixty-nine of 191 patients (36-1%) were presently affected by AT or alopecia universalis. There was a statistically significant tendency of severe patterns of AA to worsen over time. In children, 18 of 39 (13 with < or =S2 disease and 5 with > or =S3 disease) with AA had developed AT or alopecia universalis at long-term follow-up. In children, however, this trend was not statistically significant. Patients with severe AA who responded to topical immunotherapy seem to have a better prognosis than nonresponders. LIMITATIONS: Follow-up was only performed by phone. CONCLUSIONS: Severity of AA at time of first consultation is an important prognostic factor. Response to therapy (topical immunotherapy) may be associated with better prognosis. In children, the prognosis is worse; our study found that AA worsens over time. SN - 1097-6787 UR - https://www.unboundmedicine.com/medline/citation/16908349/Alopecia_areata:_a_long_term_follow_up_study_of_191_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0190-9622(06)01288-6 DB - PRIME DP - Unbound Medicine ER -