Late‐onset alopecia areata: A retrospective study of 73 patients from Taiwan

Wu, Ming‐Ho; Yang, Chao‐Chun; Tsai, Ren‐Yeu; Chen, W. C.

doi:10.1111/j.1468-3083.2012.04467.x

Cited by 23 publications

(48 citation statements)

References 23 publications

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“…Seven cross-sectional studies reported that the prevalence of both AA and personal history of atopy in adults ranges from 22 to 38% when confounding variables are considered [2, 13-18]. Results regarding the association of AA and atopy in adults is controversial, with some studies suggesting that patients with atopy also present more frequently with severe AA [2, 16] and other studies reporting a lack of an association between patients with AA and a personal history of atopy [13, 19].…”

Section: Resultsmentioning

confidence: 99%

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

Sung

Choi

Juhász

et al. 2019

Skin Appendage Disord

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Background: While alopecia areata (AA) has been associated with atopy, the immunological relationship is unclear, with the association of specific atopic and systemic respiratory diseases not established. The relationship between T-helper (Th)1-mediated AA and Th2-mediated atopy challenges the conventional Th1/Th2 paradigm of autoimmune disease categorization. Objectives: To determine the association between AA and atopic respiratory diseases in adults and children, and respiratory diseases in general. Method: All primary literature, excluding case reports, were identified within PubMed/MEDLINE, CINAHL, and Web of Science in May 2018 using the following search terms: “(alopecia OR hair loss) AND (respiratory OR pulmonary OR lungs OR asthma OR rhinitis OR bronchitis OR COPD OR atopy OR atopic).” Information from 32 articles meeting the inclusion and exclusion criteria was reviewed. Results: Among the 32 articles identified for inclusion, the prevalence of AA was more strongly associated with allergic rhinitis compared to asthma among pediatric and adult populations. While a significant association was identified between AA, allergic rhinitis, and a late age of onset, the association of AA and asthma remains controversial despite asthma’s prevalence among AA patients. No significant difference was identified with regard to the association of AA and non-atopic respiratory diseases between adult and pediatric patients. Conclusions: Adult and pediatric patients with AA warrant further workup for atopic respiratory diseases such as allergic rhinitis. AA may have an underlying Th2-mediated immunological component, which supports its association with atopic respiratory diseases and provides a new avenue for targeted therapies in select cases.

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Section: Resultsmentioning

confidence: 99%

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

Sung

Choi

Juhász

et al. 2019

Skin Appendage Disord

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“…Tan et al 15 reported that of patients in whom AA first developed before the age of 40 years, 36.5% presented with extensive AA, whereas extensive AA was only seen in 5.5% of the patients in whom AA was first observed after the age of 40 years (P < 0.05). Moreover, Wu et al 16 reported that among 73 AA patients, those in whom AA first occurred at the age of 50 years and older presented with less severe conditions, suggesting that graying hair may help to prevent AA. Our study included patients with intractable AU who were aged 40 years or older both at the onset of the condition and the start of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…The mean age of the patients was 45.7 AE 16.9 years (range, 24-66) and the mean disease duration was 9.3 AE 8.1 years (range, 1-22). The treatments administrated to the patients included topical steroids (mean, 25 months; range, 3-60), infrared therapy (mean, 15.8 months; range, 9-30), topical immunotherapy (mean, 15.4 months; range, 7-29), corticosteroid pulse therapy and cryotherapy (mean, 11 months; range, [6][7][8][9][10][11][12][13][14][15][16]. In all cases, hair loss that extended beyond the scalp was used to confirm the diagnosis of AU.…”

Section: Methodsmentioning

confidence: 99%

Three hundred and eight nanometer excimer light therapy for alopecia universalis that is resistant to other treatments: A clinical study of 11 patients

Arakawa

Nomiyama

Katoh

2016

The Journal of Dermatology

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Three hundred and eight nanometer excimer light therapy has recently been reported to be effective against patchy alopecia areata (AA) in several clinical studies. However, these studies only included a few patients with severe forms of AA, and all of them exhibited poor outcomes. We further investigated the use of excimer light as a therapeutic option for cases of alopecia universalis (AU) that are resistant to other treatments. Eleven treatmentresistant AU patients were treated with a 308-nm excimer light at 2-week intervals for more than 16 sessions. Four patients achieved good responses and two patients exhibited poor responses. Three patients had Japanese skin type 1 and all of them achieved good responses. The radiation dose was increased until the patients exhibited marked erythema. The patients with Japanese skin type 3 who achieved good responses exhibited strong pigmentation at the irradiated sites. In conclusion, 308-nm excimer light therapy has significant effects on some AU patients who are resistant to other treatments and may be an alternative therapeutic option for AU. During the treatment of AU, high doses of radiation should be administrated until a strong inflammatory skin reaction is seen.

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“…Indeed, rapid development of AA has been previously reported in cases of AA manifesting as a paraneoplastic phenomenon [12]. Furthermore, in a cohort of 73 patients with first onset of AA at the age of 50 years and above, 8% had a history of malignancy before or after the onset of AA [11]. Taken together, these reports raise the question of whether or not patients older than 40 who present for the first time with a rapidly progressing AA should be screened for malignancy with proper blood and imaging tests.…”

Section: Discussionmentioning

confidence: 99%

“…It should be taken into consideration that the severity of AA when first appearing in adults is usually mild in nature, and more than half of the adult patients with AA have less than 10% involvement of the scalp [11]. Indeed, rapid development of AA has been previously reported in cases of AA manifesting as a paraneoplastic phenomenon [12].…”

Section: Discussionmentioning

confidence: 99%

Alopecia Areata as a Manifestation of Systemic Lymphoma: Report of Two Cases

Ramot

Gural

Zlotogorski

2016

Skin Appendage Disord

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Alopecia areata is a common autoimmune disorder leading to hair loss. It usually affects individuals under the age of 40, and first appearance in older subjects is considered uncommon. Here, we report 2 cases of rapidly progressing alopecia areata, which appeared for the first time in adults. Patient 1 had alopecia universalis, which preceded the identification of hepatosplenic T-cell lymphoma, a rare form of lymphoma. Patient 2 suffered from the ophiasis type of alopecia areata, presenting for the first time following chemotherapy for non-Hodgkin B-cell lymphoma. These 2 cases highlight the need to screen for malignancies in patients who present with rapidly progressing alopecia areata for the first time after the age of 40.

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Late‐onset alopecia areata: A retrospective study of 73 patients from Taiwan

Abstract: Late-onset AA is characterized by marked female predominance and milder disease activity with increasing age. The link to cancer in the old age remains to be determined. The influence of aging on the pathogenesis and prognosis of AA deserves further studies.

Cited by 23 publications

References 23 publications

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

Three hundred and eight nanometer excimer light therapy for alopecia universalis that is resistant to other treatments: A clinical study of 11 patients

Alopecia Areata as a Manifestation of Systemic Lymphoma: Report of Two Cases

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