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INTRODUCTION: Alopecia areata is an organ-specific autoimmune disease. In addition, treatment options are limited in pediatric patients. Topical immunotherapy treatment may be preferred, especially in pediatric patients with severe and/or refractory alopecia areata. OBJECTIVES: In this study, it was aimed to examine the effect of atopic dermatitis, which is one of the poor prognostic factors in pediatric alopecia areata, on topical immunotherapy treatment. METHODS: The data of patients aged 18 years and younger who received at least 20 sessions of topical immunotherapy with the diagnosis of alopecia areata in our clinic between January 2018 and December 2020 were analyzed. RESULTS: A total of 139 patients were included in the study. The mean age of the patients was 10.29 years, 67 (48.20%) of the patients were female, 72 (51.80%) were male, 24 (17.26%) of the patients had mild disease, 115 of them (82.73%) had severe disease. Atopic dermatitis accompanying alopecia areata was detected in 38 of the patients. Inadequate response was obtained in 60 (43.17%) patients and adequate response was obtained in 79 (56.83%) patients with topical immunotherapy treatment. In addition, the presence of atopic dermatitis in the patient group with inadequate response to treatment was found to be statistically significantly higher than the patient group with adequate response to treatment. CONCLUSIONS: Topical immunotherapy treatment was found to be effective in 56.83% of pediatric alopecia areata patients included in the study. Our study showed that questioning pediatric alopecia areata patients for atopic dermatitis before topical immunotherapy treatment can predict the response to treatment.
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BACKGROUND: There are a limited number of studies evaluating the effects of alopecia areata (AA) on the health-related quality of life (HRQoL) of pediatric patients and their families. This study aimed to assess the HRQoL of pediatric patients with AA and their parents. MATERIALS AND METHODS: This single-center cross-sectional cohort study included 72 pediatric patients diagnosed with AA. The study was conducted between December 2020 and December 2021 in the dermatology department of a single tertiary center in Turkey. The HRQoL index of the pediatric patients was assessed with the Children's Dermatology Life Quality Index (CDLQI). At the same time, their parents, who were primarily involved in the disease process, were evaluated using the Dermatological Family Impact Scale (DeFIS). An ordinal logistic regression model was used to detect predictors for CDLQI severity. RESULTS: The mean ± SD CDLQI of the pediatric patients who participated in our study was 8.4 ± 5.3, corresponding to moderate impairment. The highest impairment in CDLQI was observed in the symptoms and feelings domain, while the slightest impairment was observed in the domain of personal relationships (P < 0.001). There was a statistically significant positive correlation between the Severity of Alopecia Tool (SALT) score and all CDLQI domains, and the most substantial relationship was with the leisure domain (r = 0.78, P < 0.001). DeFIS scores of female patients were substantially higher than males (25.3 ± 8.6 vs. 17.6 ± 9, P = 0.001). CONCLUSION: Our study supports that AA is a disease that significantly impacts the HRQoL of affected children and their families.
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Alopecia areata (AA) is an autoimmune disease that develops due to inflammation and causes sudden hair loss. Ithas been observed that family circumstances may contribute to the development of AA. This study aims to assessthe relationship between the development of alopecia areata in children, family functions, and depression andanxiety levels in their parents.Thirty-nine participants diagnosed with AA and 41 healthy controls (HC), agedbetween 8 and 18 years, and their parents participated in the study. The assessment of the children included thecompletion of a socio-demographic data form, the Parenting Style Scale (PSS), and the Revised Children's Anxietyand Depression Scale (RCADS). The parents provided information on a sociodemographic form, the BeckDepression Inventory (BDI), and the Beck Anxiety Inventory (BAI). The children in the control group scoredsignificantly higher on the PSS acceptance/ involvement subscale than those with AA. In the AA group, the numberof authoritative and indulgent (PSS) families was statistically significantly lower than that of the families in the HC,and the number of neglectful families was statistically significantly higher than those of the control group. Totalanxiety and depression t scores (RCADS) were statistically significantly higher in the AA children than in theHC. Our study demonstrates the importance of considering familial factors and parental mental health tounderstand and address alopecia areata in children. Our findings support the psychosomatic component of AA.Implementing comprehensive treatment strategies that target psychological well-being and family dynamics couldprove crucial.
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Alopecia Areata , Ansiedad , Depresión , Responsabilidad Parental , Humanos , Alopecia Areata/psicología , Alopecia Areata/inmunología , Alopecia Areata/epidemiología , Alopecia Areata/diagnóstico , Niño , Femenino , Masculino , Adolescente , Responsabilidad Parental/psicología , Depresión/psicología , Depresión/epidemiología , Depresión/diagnóstico , Depresión/etiología , Ansiedad/psicología , Ansiedad/epidemiología , Ansiedad/diagnóstico , Ansiedad/etiología , Padres/psicología , Estudios de Casos y ControlesRESUMEN
Psoriasis is a common multisystem inflammatory disease, and arthritis is an essential component of the disorder, requiring early diagnosis and prompt treatment for successful management. In this study, we aimed to investigate the relationship between nail and scalp involvement and other covariates with psoriatic arthritis (PsA). This cross-sectional study, conducted from June 2021 through December 2021, included 763 patients from 11 different centers in Turkey. The severity of involvement was evaluated using psoriasis area severity index (PASI), nail psoriasis severity index (NAPSI), and psoriasis scalp severity index (PSSI) scores. Predictors for PsA were evaluated using univariate and multivariate logistic regression models. PsA (nâ =â 155, 21.5%) was significantly more common in patients having a family history of psoriasis (43.2% vs 30.9%, Pâ =â .004), nail involvement (68.4% vs 52.3%, Pâ <â .001), and coexistence of nail and scalp involvement (53.7% vs 39.6%, Pâ =â .002). Furthermore, patients with PsA had considerably higher PASI (7 vs 5.6, Pâ =â .006), NAPSI (5 vs 2, Pâ <â .001), and PSSI scores (7 vs 4, Pâ =â .002) and longer disease duration (months) (126 vs 108, Pâ =â .009). In multivariate analysis, female gender [OR: 3.01, 95% CI (1.861-4.880), Pâ <â .001], nail involvement [OR: 2.06, 95% CI (1.293-3.302), Pâ =â .002)], and body mass index (BMI) [OR: 1.06, 95% CI (1.017-1.100), Pâ =â .005] were identified as independent predictors for PsA. Female gender, nail involvement, and high BMI are significant predictors for PsA and warrant detailed rheumatological assessment. Notably, being female is the strongest predictor of increased risk of PsA in our survey. Scalp involvement appears not to be associated with PsA. Also, the presence of PsA seems related to a more severe skin involvement phenotype.
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Artritis Psoriásica , Enfermedades de la Uña , Cuero Cabelludo , Índice de Severidad de la Enfermedad , Humanos , Artritis Psoriásica/epidemiología , Artritis Psoriásica/complicaciones , Estudios Transversales , Femenino , Masculino , Turquía/epidemiología , Persona de Mediana Edad , Adulto , Enfermedades de la Uña/etiología , Enfermedades de la Uña/epidemiología , Cuero Cabelludo/patología , Psoriasis/complicaciones , Psoriasis/epidemiología , Dermatosis del Cuero Cabelludo/epidemiología , AncianoRESUMEN
Background: Alopecia areata (AA) is an autoimmune disease characterized by peribulbar lymphocytic infiltration, follicular miniaturization, catagen/telogen follicles, and increased follicular stelae (streamers) in skin biopsies. Objectives: Our aim was to assess the number of follicular stelae of patients with AA and to evaluate their association with clinical type and severity and treatment response of AA. Materials and Methods: Histopathologic features including the number of follicular stelae were recorded in skin biopsies taken from lesions of AA in 142 patients who attended our dermatology clinic from 2011 to 2017. Results: There was a statistically significant correlation between patient age and the number of follicular stelae (P = 0.001). There was a statistically significant correlation between the severity of disease and number of follicular stelae (P = 0.005). AA subtypes (0%-25% scalp hair loss) had a significantly lower number of follicular stelae than 75%-100% of scalp hair loss and alopecia universalis (7.92 ± 4.21 vs. 13.23 ± 7.28). There was no statistically significant correlation between treatment response and the number of follicular stelae (P = 0.75). Conclusion: Our results showed that the number of follicular stelae varied among AA clinical types and correlated with severity. This study was the first to evaluate the correlation between the number of follicular stelae and severity of AA.