Alopecia Research Today is a free monthly online journal that collates and summarizes the latest research about Alopecia, including details on hair loss, baldness, treatment, causes, prevention.

Alopecia areata: a long term follow-up study of 191 patients.

Tosti A, Bellavista S, Iorizzo M

Department of Dermatology, University of Bologna, Italy. tosti@med.unibo.it

BACKGROUND: The prognosis of alopecia areata (AA) is difficult to predict. Few studies report long-term follow-up of AA patients. OBJECTIVE: The purpose of this study is to better assess the long-term evolution of AA and the possible relationship between disease severity and treatment response with long-term prognosis. METHODS: One hundred ninety-one patients with AA who presented with a new diagnosis of AA between 1983 and 1990 were subsequently contacted by phone. Patients were queried regarding current disease status, treatments, and disease course. RESULTS: Severity of AA at first consultation ranged from mild (128 patients) to severe (63 patients). Fifty-five of 191 patients were affected by concomitant autoimmune or related inflammatory disease. Sixty-six of 191 patients were presently disease free (follow-up duration, 15-22 years; mean 17.74 years). These include 41 of 60 patients with S1 disease (68.3%), 22 of 68 patients with S2 disease (32.3%), 1 of 11 patients with S3 disease (9%), 1 of 14 patients with S4 disease (7.1%), and 1 of 11 patients with alopecia totalis (AT) (9.1%). Sixty-nine of 191 patients (36-1%) were presently affected by AT or alopecia universalis. There was a statistically significant tendency of severe patterns of AA to worsen over time. In children, 18 of 39 (13 with < or =S2 disease and 5 with > or =S3 disease) with AA had developed AT or alopecia universalis at long-term follow-up. In children, however, this trend was not statistically significant. Patients with severe AA who responded to topical immunotherapy seem to have a better prognosis than nonresponders. LIMITATIONS: Follow-up was only performed by phone. CONCLUSIONS: Severity of AA at time of first consultation is an important prognostic factor. Response to therapy (topical immunotherapy) may be associated with better prognosis. In children, the prognosis is worse; our study found that AA worsens over time.

Published 15 August 2006 in J Am Acad Dermatol, 55(3): 438-41.
Full-text of this article is available online (may require subscription).

© 2004-2008 Alopecia Research Today. All Rights Reserved.