Correlation between the severity of alopecia areata and its risk factors

Background: Alopecia Areata (AA) is a recurrent non-scarring type of hair loss that can affect any hair-bearing area. Prognosis of AA is unpredictable and most patients experience more than one episode of hair loss. The purpose of this study was to investigate the relationship between the severity of AA with respect to age of onset, nail involvement, family history, number of recurrences and duration of the disease. Methods: A total of 239 consecutive patients with AA who were visited in our dermatology clinic from June 2009 to November 2009 were included in this study. The extent of scalp involvement, age of onset, nail involvement, family history, number of recurrences and duration of AA were recorded. Results: Two hundred and thirty nine (239) patients with AA including 141 males and 98 females entered our analysis (male: female ratio = 1.43:1). The age of the patients at the onset of the disease had a wide range from 1 to 60 years (mean ± SD = 21.51 ± 5.4). Two hundred and twelve patients (88.7%) had their first episode of AA before the age of 40 years. Duration of the AA varied from 1 month to 31 years. Ninety six (40.2%) patients experienced only one episode and 25 patients (10.5%) had more than 4 episode of alopecia. Nail changes was reported in 34 patients (14.2%). Forty five patients (18.8%) had a positive family history of alopecia areata. A personal history of atopy and autoimmune diseases was seen in 23 (9.6%) and 27 (11.3%) patients, respectively. The relationship between extensive AA and age of onset, duration, nail changes and positive family history was confirmed (p 0.05). Conclusion: AA occurred at a comparatively younger age. There was a correlation between extensive alopecia areata and age of onset, duration, nail changes, and positive family history as prognostic factors. There were no relationships between the severity of AA and sex, history of atopy and autoimmune diseases.