Long Term Follow-Up Study of Corticosteroid-Treated Patients with Alopecia Areata

Lee, Jae Chul; Kim, Ho Youn; Kim, Hyo Jin; Kim, Byung Soo; Lee, Weon Ju; Lee, Seok Jong; Kim, Do Won

Abstract

BACKGROUND: Most patients with alopecia areata usually recover spontaneously, but others develop a severe chronic form. Although many studies have been done, the prognosis and clinical course of alopecia areata are variable and hardly predictable.
OBJECTIVE
To identify the prognostic factors and the reasonable follow-up period by evaluating the clinical course of corticosteroid-treated patients with alopecia areata.
METHODS
We reviewed the medical records of 201 patients with alopecia areata who were treated with corticosteroid and followed up for more than 3 years. Among them we chose 143 patients as final subjects who were followed up for more than 5 years. Additionally we made phone calls to patients who had not visited recently. We surveyed the clinical course of alopecia areata and assessed the relationship between the clinical course and other factors such as duration of the disease before the visit, extent and type of alopecia, age at onset, age at first visit, family history, emotional stress, ophiasis, nail change, atopy and other autoimmune diseases.
RESULTS
Patients with a short duration before their first visit, small extent of alopecia, few lesions and emotional stress before onset showed a good prognosis significantly (p<0.05). Age at onset, age at first visit and family history of alopecia areata did not influence the prognosis. Ophiasis, nail change, atopy and other autoimmune diseases were excluded from prognostic factors because the number of patients was so small.
CONCLUSION
In this study, the major prognostic factors were duration of disease before first visit, extent and type of alopecia. Age at onset, age at first visit and family history of alopecia areata were not related to the prognosis.