Ranawaka R R
Department of Dermatology, Base Hospital, Homagama, Sri Lanka.
Ceylon Med J. 2014 Dec;59(4):128-31. doi: 10.4038/cmj.v59i4.7865.
The objectives were to assess the demographical pattern, clinical presentation and therapeutic response in a cohort of patients with alopecia areata (AA) in Sri Lanka.
Hospital-based observational study of 290 adults aged 18 years or above.
Alopecia areata was commoner in men (M:F=1.3:1). Age of onset was between 20-35 years (median 31 years) in 61%. Those with juvenile-onset AA (≤ 17 years, n=5) showed severe disease with many relapses and resistance to therapy. Late-onset AA (<50 years, n=12) was commoner among females and had mild disease activity. Alopecia areata was the commonest clinical type (93.7%), followed by alopecia universalis (n=10), ophiasis pattern (n=3), alopecia totalis (n=3), and reverse ophiasis pattern (n=1). Mild disease (>10% scalp area) was the commonest (82%). Alopecia was total, universal or extensive (>10% scalp area) in 18%. Sites involved were scalp (71%), beard only (20.5%) and multiple sites (8.7%). Nail changes were associated with severe disease. Associated autoimmune diseases were vitiligo 6 (2%), thyroid disease 5 (1.7%) and rheumatoid arthritis 1 (0.3%). Atopy (21%) was not associated with younger age of onset or severity of disease. Patients with a family history among first degree relatives had earlier onset of disease. Most (61%) were cured after 1-2 intralesional steroid injections. Oral dexamethasone mini pulse with or without topical 5% minoxidil lotion for 12 months or more were used in 28%.
In Sri Lanka AA is a disease of the young. Extensive disease, juvenile onset, and associated nail changes were poor prognostic factors.
评估斯里兰卡斑秃（AA）患者队列的人口统计学模式、临床表现和治疗反应。
基于医院对290名18岁及以上成年人进行的观察性研究。
斑秃在男性中更为常见（男：女 = 1.3：1）。61%的患者发病年龄在20至35岁之间（中位年龄31岁）。青少年期发病的斑秃患者（≤17岁，n = 5）病情严重，多次复发且对治疗有抵抗性。晚发型斑秃（<50岁，n = 12）在女性中更为常见，疾病活动度较轻。斑秃是最常见的临床类型（93.7%），其次是全秃（n = 10）、匐行性斑秃（n = 3）、普秃（n = 3）和反匐行性斑秃（n = 1）。轻度疾病（头皮面积>10%）最为常见（82%）。18%的患者脱发为完全性、普遍性或广泛性（头皮面积>10%）。受累部位为头皮（71%）、仅胡须部位（20.5%）和多个部位（8.7%）。甲改变与严重疾病相关。相关的自身免疫性疾病有白癜风6例（2%）、甲状腺疾病5例（1.7%）和类风湿关节炎1例（0.3%）。特应性（21%）与发病年龄较轻或疾病严重程度无关。一级亲属中有家族史的患者发病较早。大多数患者（61%）在1 - 2次皮损内注射类固醇后治愈。28%的患者使用口服地塞米松小剂量脉冲疗法，联合或不联合外用5%米诺地尔洗剂，持续12个月或更长时间。
在斯里兰卡，斑秃是一种年轻人易患的疾病。广泛性疾病、青少年发病和相关的甲改变是不良预后因素。
