Alopecia areata in children.

OBJECTIVE

To determine the clinical presentations of alopecia areata in children as well as the frequency of associated disorders.

DESIGN

Cross-sectional study.

PLACE AND DURATION OF STUDY

Department of Dermatology, Ziauddin University Hospital, KDLB Campus, Karachi during the calendar years 2005 and 2006.

PATIENTS AND METHODS

Children of either gender suffering from alopecia areata, upto 15 years of age, who fulfilled the selection criteria were included in the study. Only freshly registered cases were studied. Severity of the disease was graded as mild, moderate and severe disease, and other clinical patterns including alopecia totalis, alopecia universalis and ophiasis. Hematological and biochemical profile was evaluated. Chi-square test was applied for statistical analysis in order to determine p-value using the percentages of variables.

RESULTS

One hundred and fourteen patients comprising 54 males (47%) and 60 females (53%), aged 4 upto 15 years, the mean age being 9.1 years, were enrolled. Family history of alopecia areata was positive in 11 patients (10%). Fifty nine patients (51%) were of age 6-10 years, 39 patients (35%), aged 11-15 years, and 16 (14%) were of age below 5 years. Mild alopecia areata (41%, p < 0.05) was the most common presentation followed by moderate disease (31%, p < 0.05), severe alopecia (17%, p < 0.05), alopecia totalis (7%, p < 0.05), alopecia universalis (2.7%, p=0.05) and ophiasis (1.7%, p=0.05). Nail changes were found in 40 patients (35%, p < 0.05). Definite evidence of atopy was obtained in 23 patients (20%, p< 0.05). The autoimmune disorders associated with alopecia areata included: hypothyroidism (4.3%), vitiligo (3.5%), psoriasis (1.8%), systemic lupus erythematosus (SLE 0.9%), hypoparathyroidism (0.9%) and diabetes mellitus (0.9%).

CONCLUSION

The spectrum of childhood alopecia areata ranges from mild, moderate and severe alopecia, ultimately to alopecia totalis, alopecia universalis and ophiasis. Nail changes as well as atopy and autoimmune disorders are the associated disorders.