An investigation of poor prognostic factors in patients with alopecia areata and their relativesHatice Ergün Duman1, Afet Akdağ Köse1, Halim İşsever21Department Of Dermatology And Venereology, Istanbul Medical Faculty, University Of Istanbul, Istanbul, Turkey
2Department Of Public Health, Istanbul Medical Faculty, University Of Istanbul, Istanbul, Turkey
Background and Design: Alopecia areata (AA) is characterized by non-scatricial hair loss with exacerbations and remissions. Although its etiopathogenesis is not known, autoimmune factors have been suggested. Our aim was to make contribution to the epidemiological properties of AA in Turkey, and to determine the bad prognostic factors that affect the course of the disease.
Materials and Methods: One hundred and thirty-four patients who applied to the Dermatology and Venereology Polyclinic in Istanbul Medical Faculty, Istanbul University were included in the study. The patients were investigated retrospectively in terms of the age, gender, clinical type, involved area of alopecia, severity of the disease, number of relapses, disease duration, age at disease onset, presence of nevus flammeus, nail involvement, history of emotional and/or physical stress, history of AA within the family, and history of atopia within the patients and their relatives.
Results: Of the 134 patients, 79 (59 percent) were male, 55 (41 percent) were female and M/F: 1.4/1. The clinical type was AA in 86.5%, alopecia totalis (AT) in 3.7% and alopecia universalis (AU) in 9.7% of the cases. The most common involment was the scalp in both genders and clinically 92.1% was patchy. Severe involvement was found significant in the female patients (p=0.029), in the juvenile onset (p=0.001), in ≥1 year of disease duration (p=0.001), in the presence of nevus flammeus (p=0.017) and in the nail involvement (p=0.015). In the 27.6% of the cases, the family history of AA was present and that was higher in the juvenile group (p=0.034).There was no association between the severity of the disease and atopia.
Conclusion: Alopecia areata follows a more severe course in the female patients, juvenile onset patients, patients with nail involvement, patients with nevus flammeus, patients with long disease duration, and patients with the family history of AA than the others. Keywords: Alopecia areata, demographical and clinical properties, prognostic factors
Alopesi areatalı olgularda ve yakınlarında kötü prognostik faktörlerin incelenmesiHatice Ergün Duman1, Afet Akdağ Köse1, Halim İşsever21İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Deri Ve Zührevi Hastalıklar Anabilim Dalı, İstanbul, Türkiye
2İstanbul Üniversitesi, İstanbul Tıp Fakültesi, Halk Sağlığı Anabilim Dalı, İstanbul, Türkiye
Giriş ve Amaç: Alopesi areata (AA), skar yapmayan saç kaybı ile alevlenme ve remisyonlarla seyreden bir hastalıktır. Etyopatogenezi tam olarak bilinmemekle beraber otoimmün hipotez üzerinde durulmaktadır. Alopesi areata olgularının klinik ve demografik özellikleri incelenerek Türkiye’de AA’nın epidemiyolojik özelliklerine katkı sağlanması ve hastalık seyrine etkili kötü prognostik faktörlerin ortaya konulması amaçlandı.
Gereç ve Yöntem: İstanbul Üniversitesi, İstanbul Tıp Fakültesi Deri ve Zührevi Hastalıklar Anabilim Dalı Polikliniğine başvurmuş 134 hasta çalışmaya alındı. Hastalar yaş, cinsiyet, klinik tip, alopesi tutulum alanı, hastalık şiddeti, atak sayısı, hastalık süresi, hastalık başlangıç yaşı, nevus flammeus varlığı, tırnak tutulumu, emosyonel ve/veya fiziksel stres öyküsü, ailede AA öyküsü, ailede ve hastada atopi öyküsü açısından retrospektif olarak incelendi.
Bulgular: Çalışmaya alınan 134 hastanın 79’u erkek (%59), 55’i kadın (%41), erkek: kadın oranı 1.4: 1, klinik olarak %86.5 AA, %3.7 alopesi totalis (AT), %9.7 alopesi universalis (AU) idi. Her iki cinste en sık saçlı deri tutulumu vardı ve %92.1 (n=93) yama idi. Şiddetli tutulum; kadınlar (p=0.029), juvenil başlangıç (p=0.001), ≥1 yıl hastalık süresi (p=0,001), nevus flammeus varlığı (p=0.017) ve tırnak tutulumunda (p=0.015) anlamlı bulundu. Olguların %27.6’sında ailede AA hikayesi vardı ve juvenil grupta yüksek idi (p=0.034). Hastalık şiddeti ile atopi arasında ilişki yoktu (p>0.05).
Sonuç: Alopesi areata; kadınlar, juvenil başlangıç, tırnak tutulumu, nevus flammeus varlığı, uzun hastalık öyküsü, ailede AA hikayesinde şiddetli seyretmektedir. Anahtar Kelimeler: Alopesi areata, demografik ve klinik özellikler, prognostik faktörler
Hatice Ergün Duman, Afet Akdağ Köse, Halim İşsever. An investigation of poor prognostic factors in patients with alopecia areata and their relatives. Turkderm-Turk Arch Dermatol Venereol. 2015; 49(1): 37-40
Corresponding Author: Hatice Ergün Duman, Türkiye |
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