Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2012 Jul;27(7):799-802. doi: 10.3346/jkms.2012.27.7.799. Epub 2012 Jun 29.
Alopecia totalis (AT) and alopecia universalis (AU), severe forms of alopecia areata (AA), show distinguishable clinical characteristics from those of patch AA. In this study, we investigated the clinical characteristics of AT/AU according to the onset age. Based on the onset age around adolescence (< or ≥ 13 yr), 108 patients were classified in an early-onset group and the other 179 patients in a late-onset group. We found that more patients in the early-onset group had a family history of AA, nail dystrophy, and history of atopic dermatitis than those in the late-onset group. These clinical differences were more prominent in patients with AU than in those with AT. In addition, significantly more patients with concomitant medical disorders, especially allergic diseases were found in the early-onset group (45.8%) than in the late-onset group (31.2%). All treatment modalities failed to show any association with the present hair condition of patients. In the early-onset group, patients with AU or a family history of AA showed worse prognosis, whereas this trend was not observed in the late-onset group. Systemic evaluations might be needed in early-onset patients due to the higher incidence of comorbid diseases. It is suggested that patients with AU or family history of AA make worse progress in the early-onset group than in the late-onset group.
全秃（AT）和普秃（AU）是斑秃（AA）的严重形式，其临床表现与斑片状 AA 有明显区别。本研究根据发病年龄探讨 AT/AU 的临床特征。依据发病年龄是否在青春期（<或≥13 岁），108 例患者被分为早发型组，另 179 例患者为晚发型组。我们发现早发型组患者 AA 家族史、甲营养不良和特应性皮炎病史的比例明显高于晚发型组。这些临床表现的差异在 AU 患者中比 AT 患者更为明显。此外，早发型组（45.8%）并发其它疾病，尤其是过敏疾病的患者明显多于晚发型组（31.2%）。所有治疗方法均与患者目前的毛发状况无关。早发型组中 AU 或 AA 家族史患者预后较差，但在晚发型组中并未观察到这种趋势。早发型患者可能需要进行全身评估，因为其合并症的发病率较高。提示早发型组 AU 或 AA 家族史患者的病情较晚发型组进展更为严重。
