Alopecia areata and health-related quality of life: a systematic review and meta-analysis

Rencz, Fanni; Gulàcsi, László; Péntek, Márta; Wikonkál, Norbert; Baji, Petra; Brodszky, Valentin

doi:10.1111/bjd.14497

Cited by 168 publications

(194 citation statements)

References 45 publications

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“…Another study searched six electronic databases of 479 studies on effects of alopecia areata on health-related QOL; 21 studies with 2,530 patients met inclusion criteria. 183 The meta-analysis of SF-36 studies detected a significantly reduced health-related QOL across the role-emotional, mental health and vitality domains (P<0.001). Scalp involvement, anxiety and depression had a negative effect on health-related QOL with conflicting results for age, gender, marital status and disease duration, but wearing a wig had a positive impact 183 .…”

Section: Mechanisms/pathophysiologymentioning

confidence: 95%

“…183 The meta-analysis of SF-36 studies detected a significantly reduced health-related QOL across the role-emotional, mental health and vitality domains (P<0.001). Scalp involvement, anxiety and depression had a negative effect on health-related QOL with conflicting results for age, gender, marital status and disease duration, but wearing a wig had a positive impact 183 . Alopecia areata has a profound effect on self-awareness owing to the psychological impact of negative beliefs and emotions 185 .…”

Section: Mechanisms/pathophysiologymentioning

confidence: 95%

“…The effects of alopecia, including alopecia areata, on physical health status is measured by morbidity and mortality data commonly used to evaluate health conditions, but the QOL of alopecia patients may significantly differ (Box 4) 182,183 . The physical, mental and social aspects of a healthy person with alopecia is very different from those individuals with chronic medical or physical disability.…”

Section: Mechanisms/pathophysiologymentioning

confidence: 99%

“…To address the need to better define factors affecting QOL of patients with alopecia areata, self-assessment health instruments, such as Dermatology Life Quality Index and the 36-item Short Form Health Survey (SF-36), are used 5,183 . Alopecia areata-specific instruments have also been developed, including the Alopecia Areata Quality of Life Index, Alopecia Areata Quality of Life and Alopecia Areata Symptom Impact Scale.…”

Section: Mechanisms/pathophysiologymentioning

confidence: 99%

“…Alopecia areata-specific instruments have also been developed, including the Alopecia Areata Quality of Life Index, Alopecia Areata Quality of Life and Alopecia Areata Symptom Impact Scale. 183 Health-related QOL assessments using Skindex-16 (a brief version of Feel of Negative Evaluation Scale and Dermatology Life Quality Index) of 532 patients enrolled in the US National Alopecia Areata Registry were compared to previously reported health-related QOL levels from healthy controls and patients with other skin diseases 5 . Risk factors for poor health-related QOL were age 20–50 years of age, female sex, light skin color, hair loss of 25–99% on the scalp surface, family stress and change in employment.…”

Section: Mechanisms/pathophysiologymentioning

confidence: 99%

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Alopecia areata

Pratt

King

Messenger

et al. 2017

Nat Rev Dis Primers

553

528

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Alopecia areata is an autoimmune disorder characterized by transient, non-scarring hair loss and preservation of the hair follicle. Hair loss can take many forms ranging from loss in well-defined patches to diffuse or total hair loss, which can affect all hair bearing sites. Patchy alopecia affecting the scalp is the most common type. Alopecia areata affects nearly 2% of the general population at some point during their lifetime. Skin biopsies of alopecia areata affected skin show a lymphocytic infiltrate in and around the bulb or the lower part of the hair follicle in anagen (hair growth) phase. A breakdown of immune privilege of the hair follicle is thought to be an important driver of alopecia areata. Genetic studies in patients and mouse models showed that alopecia areata is a complex, polygenic disease. Several genetic susceptibility loci were identified associated with signaling pathways that are important to hair follicle cycling and development. Alopecia areata is usually diagnosed based on clinical manifestations, but dermoscopy and histopathology can be helpful. Alopecia areata is difficult to manage medically, but recent advances in understanding the molecular mechanisms have revealed new treatments and the possibility of remission in the near future.

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Section: Mechanisms/pathophysiologymentioning

confidence: 95%

Section: Mechanisms/pathophysiologymentioning

confidence: 95%

Section: Mechanisms/pathophysiologymentioning

confidence: 99%

Section: Mechanisms/pathophysiologymentioning

confidence: 99%

Section: Mechanisms/pathophysiologymentioning

confidence: 99%

See 3 more Smart Citations

Alopecia areata

Pratt

King

Messenger

et al. 2017

Nat Rev Dis Primers

553

528

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Health-Related Quality of Life in Patients With Frontal Fibrosing Alopecia

et al. 2018

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All-Cause and Cause-Specific Mortality Risks Associated With Alopecia Areata

Lee

Kim

et al. 2019

JAMA Dermatol

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IMPORTANCE Alopecia areata is associated with diverse systemic and psychiatric diseases. However, whether all-cause and cause-specific mortality in patients with alopecia areata differs from that of the general population remains unclear. OBJECTIVE To investigate all-cause and cause-specific mortality risk in patients with alopecia areata. DESIGN, SETTING, AND PARTICIPANTS Using the National Health Insurance Service database and National Death Registry of Korea, a retrospective cohort study of participants identified in 2006, with investigation of mortality until 2016, was carried out. Patients with alopecia areata with at least 3 documented visits to a dermatologist with an International Statistical Classification of Diseases (tenth revision) code of L63 during 2002 to 2006 were included. For comparison, 1:10 age-and sex-matched controls without documented visits with a code of L63 until 2016 were included. EXPOSURES Patients with alopecia areata and controls without alopecia areata. MAIN OUTCOMES AND MEASURES The study population was followed from January 1, 2007, for a period of 10 years to estimate all-and cause-specific mortality. RESULTS The study comprised 73 107 patients with alopecia areata and 731 070 age-and sex-matched controls. Of these, 6023 were patients with alopecia totalis/universalis. No differences in all-cause mortality risk between the cohorts were found (HR, 0.97; 95% CI, 0.87-1.09). However, mortality associated with intentional self-harm/psychiatric diseases was greater in patients than in participants in the control group (HR, 1.21; 95% CI, 1.04-1.41). Adult patients aged 35 years or younger (HR, 1.68; 95% CI, 1.32-2.12) and those with alopecia totalis/universalis (HR, 1.85; 95% CI, 1.25-2.75) were particularly affected. Mortality associated with lung cancer was greater in patients with alopecia totalis/universalis (HR, 2.16; 95% CI, 1.41-3.33). However, mortality associated with diabetes mellitus was significantly lower in patients with alopecia areata (HR, 0.53; 95% CI, 0.36-0.79). CONCLUSIONS AND RELEVANCE Patients with alopecia areata have a higher risk of mortality associated with self-harm, psychiatric diseases, and smoking-associated malignant diseases including lung cancer. For better outcomes, clinicians should appropriately treat patients to ensure emotional and psychological well-being.

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Alopecia areata and health-related quality of life: a systematic review and meta-analysis

Cited by 168 publications

References 45 publications

Alopecia areata

Alopecia areata

Health-Related Quality of Life in Patients With Frontal Fibrosing Alopecia

All-Cause and Cause-Specific Mortality Risks Associated With Alopecia Areata

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