Turkderm-Turk Arch Dermatol Venereol. 2015; 49(1): 37-40 | DOI: 10.4274/turkderm.84666

An investigation of poor prognostic factors in patients with alopecia areata and their relatives

Hatice Ergün Duman¹, Afet Akdað Köse¹, Halim Ýþsever^2
1Department 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

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Alopesi areatalý olgularda ve yakýnlarýnda kötü prognostik faktörlerin incelenmesi

Hatice Ergün Duman¹, Afet Akdað Köse¹, Halim Ýþsever^2
1Ýstanbul Üniversitesi, Ýstanbul Týp Fakültesi, Deri Ve Zührevi Hastalýklar Anabilim Dalý, Ýstanbul, Türkiye
²Ýstanbul Üniversitesi, Ýstanbul Týp Fakültesi, Halk Saðlýðý Anabilim Dalý, Ýstanbul, Türkiye

Giriþ ve Amaç: Alopesi areata (AA), skar yapmayan saç kaybý ile alevlenme ve remisyonlarla seyreden bir hastalýktýr. Etyopatogenezi tam olarak bilinmemekle beraber otoimmün hipotez üzerinde durulmaktadýr. Alopesi areata olgularýnýn klinik ve demografik özellikleri incelenerek Türkiye’de AA’nýn epidemiyolojik özelliklerine katký saðlanmasý ve hastalýk seyrine etkili kötü prognostik faktörlerin ortaya konulmasý amaçlandý.
Gereç ve Yöntem: Ýstanbul Üniversitesi, Ýstanbul Týp Fakültesi Deri ve Zührevi Hastalýklar Anabilim Dalý Polikliniðine baþvurmuþ 134 hasta çalýþmaya alýndý. Hastalar yaþ, cinsiyet, klinik tip, alopesi tutulum alaný, hastalýk þiddeti, atak sayýsý, hastalýk süresi, hastalýk baþlangýç yaþý, nevus flammeus varlýðý, týrnak tutulumu, emosyonel ve/veya fiziksel stres öyküsü, ailede AA öyküsü, ailede ve hastada atopi öyküsü açýsýndan retrospektif olarak incelendi.
Bulgular: Çalýþmaya alýnan 134 hastanýn 79’u erkek (%59), 55’i kadýn (%41), erkek: kadýn oraný 1.4: 1, klinik olarak %86.5 AA, %3.7 alopesi totalis (AT), %9.7 alopesi universalis (AU) idi. Her iki cinste en sýk saçlý deri tutulumu vardý ve %92.1 (n=93) yama idi. Þiddetli tutulum; kadýnlar (p=0.029), juvenil baþlangýç (p=0.001), ≥1 yýl hastalýk süresi (p=0,001), nevus flammeus varlýðý (p=0.017) ve týrnak tutulumunda (p=0.015) anlamlý bulundu. Olgularýn %27.6’sýnda ailede AA hikayesi vardý ve juvenil grupta yüksek idi (p=0.034). Hastalýk þiddeti ile atopi arasýnda iliþki yoktu (p>0.05).
Sonuç: Alopesi areata; kadýnlar, juvenil baþlangýç, týrnak tutulumu, nevus flammeus varlýðý, uzun hastalýk öyküsü, ailede AA hikayesinde þiddetli seyretmektedir.

Anahtar Kelimeler: Alopesi areata, demografik ve klinik özellikler, prognostik faktörler

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