Korean J Dermatol.  2020 Jul;58(6):397-405.

Characteristics and Prognosis of Alopecia Areata in Different Age Groups: A Retrospective Long-term Follow-up Study

• Jo SY
• Go JW
• Heo EP

Abstract

Background
Alopecia areata is an autoimmune disease that presents as non-scarring hair loss and can affect all age groups. The clinical course of alopecia areata is unpredictable.
Objective
This study aimed to analyze the characteristics, treatment response, and relapse rate of alopecia areata in patients of different ages with long-term follow-up.
Methods
The medical records of 121 patients diagnosed with alopecia areata were retrospectively reviewed, and their prognosis was assessed on the basis of various indices.
Results
A total of 121 patients, including 24 cases of childhood-onset, 83 adult-onset, and 14 late-onset alopecia areata, were analyzed. In the first episode, 72.7%, 14.7%, and 9.9% of patients had mild, moderate, and severe alopecia areata, respectively. A significant and complete response was observed in 66.7%, 89.2%, and 100% of childhood-onset, adult-onset, and late-onset patients, respectively. The duration of the initial episode showed a negative correlation with age. The overall frequency of relapse was 47.1%, whichc significantly declined with time, with a majority (63.3%) of relapses occurring in the first year. Younger age at initial presentation and thyroid diseases were strongly associated with poor prognosis.
Conclusion
Younger patients showed a tendency of poor prognosis regardless of the prognostic factors. A longer follow-up period might be required for the younger onset patients.

Keyword

Age of onset; Alopecia areata; Prognosis