Kakourou T, Karachristou K, Chrousos G
First Department of Pediatrics, Athens University Medical School, Aghia Sophia Children's Hospital, 11527 Athens, Greece.
J Eur Acad Dermatol Venereol. 2007 Mar;21(3):356-9. doi: 10.1111/j.1468-3083.2006.01931.x.
The epidemiology of alopecia areata (AA) is well documented in adults but has not been studied adequately in children.
To evaluate the clinical and epidemiological profile of AA in children and assess the significance of thyroid screening.
One hundred and fifty-seven children (83 boys, 74 girls, aged 1-16 years) who visited our clinic with a first episode of AA from 1996 to 2000 were retrospectively studied. One hundred children served as clinical controls.
The age of peak incidence of AA was 0-5 years. The youngest child was 1 year old. In the majority of the cases (131/157, 83.4%) the disease was mild or moderate (less than 50% hair loss). In 15 patients (9.5%), AA was preceded by a stressful event. Five patients had a personal history of autoimmune disease (3.2 vs. 5% of the controls, (P = not significant [NS]) while 18 patients had a personal history of atopy (11.4 vs. 18% of the controls, P = NS). Twenty-one patients had a family history of autoimmune disease other than thyroiditis (13.4 vs. 5% of the controls, P = 0.04), while 23 patients had a family history of thyroid disorder (14.6 vs. 3% of the controls, P = 0.006). In eight patients (5%) subclinical hypothyroidism of autoimmune aetiology (Hashimoto's thyroiditis) was revealed at the time of investigation. Six out of the eight patients with Hashimoto's thyroiditis had a family history of thyroid disorder, which was statistically significant when compared to AA patients without thyroiditis (P < 0.001). The severity of AA was associated with early age of onset of the disease (P = 0.02).
The age of peak incidence of AA in children is 0-5 years. Children with AA have an increased family history of autoimmunity, and, among children with a first episode and short duration of AA (< 6 months), thyroid screening might be restricted in those with a positive family history of thyroid disorder. Thyroid screening should be routinely performed in all children with long-standing AA.
斑秃（AA）在成人中的流行病学情况已有充分记载，但在儿童中尚未得到充分研究。
评估儿童斑秃的临床和流行病学特征，并评估甲状腺筛查的意义。
对1996年至2000年期间因首次发作斑秃前来我院就诊的157名儿童（83名男孩，74名女孩，年龄1至16岁）进行回顾性研究。100名儿童作为临床对照。
斑秃的发病高峰年龄为0至5岁。最小的患儿为1岁。大多数病例（131/157，83.4%）病情为轻度或中度（脱发少于50%）。15例患者（9.5%）在斑秃发作前有应激事件。5例患者有自身免疫性疾病个人史（占对照组的3.2%，而对照组为5%，P =无显著差异[NS]），18例患者有特应性个人史（占对照组的11.4%，而对照组为18%，P = NS）。21例患者有除甲状腺炎外的自身免疫性疾病家族史（占对照组的13.4%，而对照组为5%，P = 0.04），23例患者有甲状腺疾病家族史（占对照组的14.6%，而对照组为3%，P = 0.006）。在调查时，8例患者（5%）发现有自身免疫病因的亚临床甲状腺功能减退（桥本甲状腺炎）。8例桥本甲状腺炎患者中有6例有甲状腺疾病家族史，与无甲状腺炎的斑秃患者相比具有统计学意义（P < 0.001）。斑秃的严重程度与疾病的早发年龄相关（P = 0.02）。
儿童斑秃的发病高峰年龄为0至5岁。斑秃患儿的自身免疫家族史增加，对于首次发作且病程较短（< 6个月）的斑秃患儿，若有甲状腺疾病家族史阳性，甲状腺筛查可能受限。对于所有病程较长的斑秃患儿，应常规进行甲状腺筛查。
