Burden of Illness in Alopecia Areata: A Cross-Sectional Online Survey Study

Mesinkovska, Natasha Atanaskova; King, Brett; Mirmirani, Paradi; Ko, Justin; Cassella, James V.

doi:10.1016/j.jisp.2020.05.007

Cited by 53 publications

(112 citation statements)

References 20 publications

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“…Another plausible explanation for this unexpected SALT 25–49% tertile finding is the greater daily emotional and activity-limiting burden to cosmetically conceal and manage smaller patchy areas of hair loss compared with patients with far greater or complete scalp hair loss (AT/AU). The latter group (SALT 75–100%) may, in general, focus less on these concealment challenges and instead sport a bald or prothesis-covered scalp, thus reducing: (1) the amount of time focused on daily concealing activities [ 40 ], (2) the emotional concerns of being “found out” if the concealment is imperfect or becomes disrupted, and (3) activity limitations necessary to avoid water, sweat, and/or wind that could disrupt cosmetic concealment of scalp hair loss. These possible explanations elucidate the need for future research to better understand this finding of greatest emotional and activity impact in the 25–49% SALT tertile.…”

Section: Discussionmentioning

confidence: 99%

Validation of the Alopecia Areata Patient Priority Outcomes (AAPPO) Questionnaire in Adults and Adolescents with Alopecia Areata

Wyrwich

Winnette

Bender

et al. 2021

Dermatol Ther (Heidelb)

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Introduction: Individuals with alopecia areata (AA) may experience significant impacts on their health-related quality of life. The novel Alopecia Areata Patient Priority Outcomes (AAPPO) questionnaire has been developed to assess hair loss signs, emotional symptoms, and activity limitations associated with AA. The objective of this study was to evaluate psychometric properties and establish scoring of the AAPPO in adults and adolescents with AA. Methods: Scoring and measurement properties of the AAPPO were examined using baseline and 2-week follow-up data from a prospective, noninterventional, web-based study of 121 patients with AA (85 adults aged C 18 years, 36 adolescents aged 12-17 years) with Severity of Alopecia Tool (SALT) C 25% scalp hair loss. Results: Exploratory and confirmatory factor analysis supported four single Hair Loss (HL) items, an Emotional Symptoms domain (ES; 4 items), and an Activity Limitations domain (AL; 3 items). Among all patients, the multi-item ES and AL domains had strong internal consistency (a C 0.87); all HL items and domain scores had strong test-retest reliability (weighted kappa or intraclass correlation coefficients C 0.78). All HL item scores demonstrated strong construct validity (r C 0.52) compared with the patient-reported Alopecia Areata Symptom and Impact Scale (AASIS) hair loss subscale score; ES and AL domain scores exhibited strong construct validity (r C 0.66) compared with the SF-36 Mental Component Summary (MCS) score. Using SALT scores, HL mean item scores were better (lower) in the 25-49% SALT subgroup versus those with highest SALT scores (76-100%); however, ES mean domain scores were better in the SALT 76-100% subgroup in the same comparison (p \ 0.0001). Using AASIS and MCS score-created subgroups, ES and AL mean domain scores demonstrated hypothesized differences across subgroups (all p values \ 0.0001). Conclusion:The AAPPO questionnaire is a reliable, valid disease-specific measure of hair loss severity and impact in individuals with AA.

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Section: Discussionmentioning

confidence: 99%

Validation of the Alopecia Areata Patient Priority Outcomes (AAPPO) Questionnaire in Adults and Adolescents with Alopecia Areata

Wyrwich

Winnette

Bender

et al. 2021

Dermatol Ther (Heidelb)

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“…The most common reason for cannabis use was to treat physical and emotional symptoms related to AA, building on previous findings which have demonstrated AA's morbidity is largely associated with psychosocial burden rather than physical discomfort or pain. [ 2 11 12 ]…”

Section: Discussionmentioning

confidence: 99%

Cannabis use among patients with alopecia areata: A cross-sectional survey study

et al. 2022

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Importance: Little is known about cannabis use among patients with alopecia areata (AA). These patients often experience significant psychosocial burden and may seek alternative therapies beyond that of traditional medical treatments, such as cannabis. Objective: To characterize cannabis use among patients with AA. Design: This was a cross-sectional study conducted from March 9, 2021, to March 22, 2021, using a web-based survey distributed to adult patients with AA using the National AA Foundation's email listserv and social media platforms. Results: 1,087 participants completed the survey (completion rate: 88.1%). Most participants were female ( n = 870, 83.3%) and Caucasian ( n = 771, 73.8%), with a mean age of 47.6 ± 15.5 years. 65.9% ( n = 689) of participants with AA had a history of cannabis use and among those, 51.8% ( n = 357) were current cannabis users. The most common reason for cannabis use among current users was for AA-related symptoms ( n = 199, 55.7%), with the greatest perceived improvement in symptoms of stress ( n = 261, 73.1%) and anxiety, sadness, and depression ( n = 234, 65.6%). 80.4% ( n = 287) indicated that cannabis had no impact on their hair loss. Conclusion: Cannabis use is common among patients with AA and is often used to alleviate the psychosocial symptoms related to AA, despite the lack of perceived improvement in hair regrowth.

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“…The psychosocial burden of AA, impacting the patient's emotional and psychological wellbeing, relationships, and lifestyle, has been described extensively. 7,13 After extent of scalp hair loss, there was broad agreement that depression, anxiety, and psychosocial impact related to AA were very important in determining AA severity (Supplemental Table I). Some of the psychosocial effects of a disease include changes in how a patient thinks about themself, their feelings, moods, beliefs, ways of coping, and relationships with family, friends, and coworkers.…”

Section: Capsule Summary Dmentioning

confidence: 99%

Development of the alopecia areata scale for clinical use: Results of an academic–industry collaborative effort

King

Mesinkovska

Craiglow

et al. 2022

Journal of the American Academy of Dermatology

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Background:The current classification for alopecia areata (AA) does not provide a consistent assessment of disease severity.Objective: To develop an AA severity scale based on expert experience.Methods: A modified Delphi process was utilized. An advisory group of 22 AA clinical experts from the United States was formed to develop this AA scale. Representatives from the pharmaceutical industry provided feedback during its development.Results: Survey responses were used to draft severity criteria, aspiring to develop a simple scale that may be easily applied in clinical practice. A consensus vote was held to determine the final AA severity statement, with all AA experts agreeing to adopt the proposed scale. Limitations:The scale is a static assessment intended to be used in clinical practice and not clinical trials. Conclusion:The final AA disease severity scale, anchored in the extent of hair loss, captures key features commonly used by AA experts in clinical practice. This scale will better aid clinicians in appropriately assessing severity in patients with this common disease.

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Burden of Illness in Alopecia Areata: A Cross-Sectional Online Survey Study

Cited by 53 publications

References 20 publications

Validation of the Alopecia Areata Patient Priority Outcomes (AAPPO) Questionnaire in Adults and Adolescents with Alopecia Areata

Validation of the Alopecia Areata Patient Priority Outcomes (AAPPO) Questionnaire in Adults and Adolescents with Alopecia Areata

Cannabis use among patients with alopecia areata: A cross-sectional survey study

Development of the alopecia areata scale for clinical use: Results of an academic–industry collaborative effort

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