Acute diffuse and total alopecia: A new subtype of alopecia areata with a favorable prognosis

Lew, Bark‐Lynn; Shin, Min Kyung; Sim, Woo‐Young

doi:10.1016/j.jaad.2008.08.045

Cited by 75 publications

(79 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Upto 50% of the patients will recover within 1 year even without treatment. The most important factors indicating a poor prognosis are the extent of hair loss present (extensive AA/AT/AU) 34 or an ophiasis pattern of hair loss, 35 atopy, a positive family history, the presence of other autoimmune diseases, nail involvement, and young age of first onset. In children, the disease may have a tendency towards worsening with time, even if the initial presentation was mild.…”

Section: Prognosismentioning

confidence: 99%

Alopecia Areata-a Clinical Analysis

Wali¹,

Patil²,

Hogade³

et al. 2013

jemds

View full text Add to dashboard Cite

Section: Prognosismentioning

confidence: 99%

Alopecia Areata-a Clinical Analysis

Wali¹,

Patil²,

Hogade³

et al. 2013

jemds

View full text Add to dashboard Cite

“…As a new variant of AA, 'acute diffuse and total alopecia (ADTA) (of the female scalp)' 7,8 and 'acute alopecia totalis,' 17 characterized by rapid progression and extensive hair loss predominantly among females, have been reported. Despite the extensive area of hair loss and rapid progression, this type of AA reportedly has a favorable prognosis.…”

Section: J Am Acad Dermatolmentioning

confidence: 99%

“…Despite the extensive area of hair loss and rapid progression, this type of AA reportedly has a favorable prognosis. 7,8 However, it is clinically difficult to distinguish RPAA with a good prognosis, such as ADTA, from RPAA presenting similarly extensive hair loss on the first visit and having a poor prognosis, resulting in chronic extensive hair loss. We studied RPAA patients, including not only rapid-onset patients who had no previous history of AA such as ADTA, but also those presenting with rapid progression of hair loss with frequent recurrences and poor prognosis.…”

Section: J Am Acad Dermatolmentioning

confidence: 99%

“…This tendency toward a favorable prognosis for RPAA is consistent with characteristics of ADTA reported by Sato-Kawamura, Aiba, and Tagami 7 and Lew, Shin, and Sim. 8 However, not all RPAA patients have a favorable prognosis and some fail to improve or progress to severe hair loss. A previous history of AA is thought to be a poor prognostic factor for patients initially diagnosed with RPAA and is related to a higher risk of relapse among these patients.…”

Section: J Am Acad Dermatolmentioning

confidence: 99%

“…4 Prognosis of AA is influenced by various factors, including age, 5,6 severity of hair loss, 6 and acute progression. 7,8 Identification of prognostic factors solely by means of univariate analysis is difficult. In the present study, 1030 patients diagnosed with AA at our clinic were retrospectively examined for 3 years, and the prognosis of 311 AA patients was assessed using multivariate analysis to identify prognostic factors as independent factors.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Uchiyama

Egusa

Hobo

et al. 2012

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

Topographic Phenotypes of Alopecia Areata and Development of a Prognostic Prediction Model and Grading System

et al. 2019

View full text Add to dashboard Cite

IMPORTANCE Diverse assessment tools and classification have been used for alopecia areata; however, their prognostic values are limited. OBJECTIVE To identify the topographic phenotypes of alopecia areata using cluster analysis and to establish a prediction model and grading system for stratifying prognoses. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study of 321 patients with alopecia areata who visited a single tertiary referral center between October 2012 and February 2017 and underwent 4-view photographic assessment. EXPOSURES Clinical photographs were reviewed to evaluate hair loss using the Severity of Alopecia Tool 2. Topographic phenotypes of alopecia areata were identified using hierarchical clustering with Ward's method. Differences in clinical characteristics and prognosis were compared across the clusters. The model was evaluated for its performance, accuracy, and interobserver reliability by comparison to conventional methods. MAIN OUTCOMES AND MEASURES Topographic phenotypes of alopecia areata and their major (60%-89%) and complete regrowth probabilities (90%-100%) within 12 months. RESULTS A total of 321 patients were clustered into 5 subgroups. Grade 1 (n = 200; major regrowth, 93.4%; complete regrowth, 65.2%) indicated limited hair loss, whereas grades 2A (n = 66; major regrowth, 87.8%; complete regrowth, 64.2%) and 2B (n = 20; major regrowth, 73.3%; complete regrowth, 45.5%) exhibited greater hair loss than grade 1. The temporal area was predominantly involved in grade 2B, but not in grade 2A, despite being comparable in total extent of hair loss. Grade 3 (n = 20; major regrowth, 45.5%; complete regrowth, 25.5%) included diffuse or extensive alopecia areata, and grade 4 (n = 15; major regrowth, 28.2%; complete regrowth, 16.7%) corresponded to alopecia (sub)totalis. No significant differences in prognosis (hazard ratio [HR] for major regrowth, 0.79; 95% CI, 0.56-1.12) were found between grades 2A and 1, whereas grades 2B (HR, 0.41; 95% CI, 0.21-0.81), 3 (HR, 0.24; 95% CI, 0.12-0.50), and 4 (HR, 0.16; 95% CI, 0.06-0.39) had significantly poorer response. Among multiple models, the cluster solution had the greatest prognostic performance and accuracy. The tree model of the cluster solution was converted into the Topography-based Alopecia Areata Severity Tool (TOAST), which revealed an excellent interobserver reliability among 4 dermatologists (median quadratic-weighted κ, 0.89). CONCLUSIONS AND RELEVANCE Temporal area involvement should be independently measured for better prognostic stratification. The TOAST is an effective tool for describing the topographical characteristics and prognosis of hair loss and may enable clinicians to establish better treatment plans.

show abstract

Acute diffuse and total alopecia: A new subtype of alopecia areata with a favorable prognosis

Cited by 75 publications

References 17 publications

Alopecia Areata-a Clinical Analysis

Alopecia Areata-a Clinical Analysis

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

Topographic Phenotypes of Alopecia Areata and Development of a Prognostic Prediction Model and Grading System

Contact Info

Product

Resources

About