Childhood Alopecia Areata: A Study Of 89 Patients

Abstract

Background and Design: Alopecia areata (AA) is a frequent type of acquired hair loss with a sudden onset. The aim of this study was to investigate the epidemiological and clinical features of AA and diseases associated with AA in the Turkish pediatric population. Materials and Methods: We retrospectively evaluated the medical data of patients under 16 years of age who were admitted to the pediatric dermatology outpatient clinic at Hacettepe University Hospital between 2006 and 2011 with a diagnosis of AA, alopecia totalis (AT) and alopecia universalis (AU). Results: A total of 89 patients (34 females and 55 males), were included in this study. The mean age of the subjects was 9.8 +/- 3.4 years (range:18 months-16 years). 9% (n=8) patients had other autoimmune diseases: Hashimoto's thyroiditis in 5, vitiligo in 1, juvenile rheumatoid arthiritis (JRA) in 1 and morphea in 1 patient. AA was located on the scalp in 86.5% (n=77) of the patients, 7.9% (n=7) of the patients had AA on the scalp together with eyelashes, eyebrows and the body. AT was noted in 1, AU was noted in 4 patients. Severity of hair loss was <25% in 94.3% (n=84) of the patients according to the involved area. Hashimoto's thyroiditis was diagnosed in 5 patients; these patients had normal thyroid function tests (TFT). TFT abnormalities were detected in 27% (n=24) of the patients. 24.7% (n=22) of these patients were diagnosed with clinically insignificant thyroid disorder, 2 patients had compansated hypothyroidism (n=2). Eight patients (9%) patients were found to be positive for anti-thyroid peroxidase antibody (Anti-TPO ab). Antithyroglobulin antibody (Anti-TG Ab) elevation was noted in 3.3% (n=3) and antinuclear antibody (ANA) positivity was noted in 9% (n=8). Nail changes were detected in 12.3% (n=11) of the patients as leukonychia (n=2), longitudinal striation (n=2), trachyonychia (n=1), onychoschizia (n=1) and pitting (n=1). Conclusion: Childhood AA usually causes limited hair loss. TFT anomalies can accompany AA without clinical symptoms. Therefore, investigation and regular follow-up of baseline TFT and anti-TPO Ab levels are suggested in patients with AA in childhood.