Comorbidities in patients with alopecia areata

Kim

et al. 2018

Acad Dermatol Venereol

The AA subjects had lower serum 25-hydroxyvitamin D level, and vitamin D deficiency was highly prevalent compared to non-AA controls. Hence, vitamin D deficiency should be assessed in AA patients. Furthermore, nutritional supplementation of vitamin D or topical vitamin D analogues can be considered for AA patients with vitamin D deficiency. The limitation of this study is the highly heterogeneity of the included studies.

Section: Discussionmentioning

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Increased prevalence of vitamin D deficiency in patients with alopecia areata: a systematic review and meta‐analysis

Kim

et al. 2018

Acad Dermatol Venereol

The Journal of Dermatology

“…These results show that PCA may be a marker of metabolic or systemic disorders, and patients with PCA require appropriate evaluation. Compared with PCA, a few large‐scale epidemiological studies reported alopecia areata (AA) and other comorbidities such as atopic dermatitis, psoriasis, thyroid diseases, vitiligo and diabetes . However, unlike AA, PCA is a rare disease, and there are limitations involved in diagnosing its comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Primary cicatricial alopecia in a single‐race Asian population: A 10‐year nationwide population‐based study in South Korea

Yoon

Choi

2018

Primary cicatricial alopecia (PCA) is a dermatological challenge. Because no large-scale epidemiological study regarding PCA is available yet, we investigated the National Health Insurance Service-National Sample Cohort for patients diagnosed with PCA. The annual and overall rates of incidence and prevalence of PCA during the study period (2004-2013) were estimated. Distribution of PCA subtypes, disease co-occurrence rates and frequently prescribed medications were also evaluated. The overall incidence was 6.10 (95% confidence interval [CI], 5.62-6.60) per 100 000 person-years. The incidence rate was stable over time (risk ratio [RR] = 1.012, P = 0.201) and lower in female patients (RR = 0.718, P < 0.001). The overall prevalence was 20.93 (95% CI, 17.97-23.86) per 100 000 persons. The average duration of PCA was calculated as 3.23 years. Approximately 70% of the patients were below the age of 45 years. Folliculitis decalvans and dissecting cellulitis were the most common subtypes of PCA. Logistic regression analysis showed that PCA was significantly associated with thyroid disorders (adjusted odds ratio = 1.64, P < 0.001). Clobetasol was the most frequently prescribed topical agent. Corticosteroids were the most common oral agents used, followed by tetracycline antibiotics. Our study is the first large-scale study reporting the epidemiology of PCA. We found a preponderance of males and neutrophil-associated subtypes of PCA, and PCA was related to thyroid disorders.

The Journal of Dermatology

“…One study had a retrospective cohort design, one study was cross‐sectional and the other 15 were case–control studies . Two studies exclusively examined adults (aged ≥18 years), one study examined children (aged <18 years) and another 14 studies included both age groups . A summary of the included studies is shown in Table .…”

Section: Resultsmentioning

confidence: 99%

“…Thyroid diseases are frequent endocrinal conditions caused by multiple factors . Several previous studies suggested a significant positive association between AA and thyroid diseases . Particularly, hypothyroidism is reported to be highly associated with AA .…”

Section: Introductionmentioning

confidence: 99%

Chronological association between alopecia areata and autoimmune thyroid diseases: A systematic review and meta‐analysis

Kinoshita‐Ise

Martínez-Cabriales

Alhusayen

2019

The association between alopecia areata (AA) and autoimmune thyroid diseases (AITD) has been suggested; however, the chronological relationship between AA and AITD remains elusive. A systematic review and meta‐analysis were conducted to assess the association between AA and AITD focusing on the prevalence of thyroid antibodies, thyroid diseases and serological thyroid dysfunctions, respectively. Data collection was performed in October 2018 by searching for articles in two electronic databases: Medline and Embase. Case–control, cohort and cross‐sectional studies were included. Meta‐analysis of studies eligible for quantitative synthesis was performed to estimate pooled odds ratios of thyroid antibodies; thyroid peroxidase antibody (TPO‐Ab) and thyroglobulin antibody (TG‐Ab), diagnosed thyroid diseases and serological thyroid dysfunctions. Four hundred and eighty nine research papers were identified and 17 studies with 262 581 patients and 1 302 655 control subjects were included for quantitative synthesis. AA was significantly associated with both TPO‐Ab and TG‐Ab. In comparison, there was no significant association between AA and diagnosed hypothyroidism or hyperthyroidism and serological hypothyroidism or hyperthyroidism. In conclusion, AA is significantly associated with the existence of thyroid antibodies rather than with clinical or laboratory thyroid abnormality. Lack of long‐term follow‐up data is a limitation of the existing published work. Our findings do not support routine screening of thyroid diseases for asymptomatic AA patients but highlight the potential future risk of AITD particularly in severe and refractory AA.