Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, H-1093, Budapest, Hungary.
Doctoral School of Clinical Medicine, Semmelweis University, Pf. 2, H-1428, Budapest, Hungary.
Br J Dermatol. 2016 Sep;175(3):561-71. doi: 10.1111/bjd.14497. Epub 2016 Jul 2.
No systematic review has yet evaluated the available evidence on health-related quality of life (HRQOL) in alopecia areata (AA).
To conduct a systematic review and meta-analysis of HRQOL studies among patients diagnosed with AA.
A systematic search was performed for papers published between 1946 and 15 December 2014 in Medline, Embase, Web of Science, CINAHL, PsycINFO and the Cochrane Library. Random-effects meta-analyses were conducted to pool data.
Twenty-one studies were included, representing a total of 2530 adult patients with AA. Of the 14 different HRQOL measures used in the studies, Dermatology Life Quality Index (DLQI; n = 8) and SF-36 (n = 7) were the most common. Three AA-specific HRQOL instruments were identified: Alopecia Areata Quality of Life Index, Alopecia Areata Quality of Life and Alopecia Areata Symptom Impact Scale. The mean pooled DLQI score of patients with AA was 6·3 (95% confidence interval 5·6-7·1). Comparing age- and sex-matched controls, the meta-analysis of SF-36 studies revealed significantly reduced HRQOL across the role-emotional, mental health and vitality domains (P < 0·001). Wearing a wig had a positive impact, while scalp involvement, anxiety and depression had a negative impact on HRQOL. Conflicting results were found regarding the association between HRQOL and age, sex, marital status and disease duration.
Patients with AA experience significant impairment in HRQOL, especially in the area of mental health. Several generic and dermatology-specific HRQOL instruments have been used, but no validation studies have confirmed their applicability in AA. The newly developed AA-specific measures seem very promising; however, a more extensive assessment of validity and reliability is needed.
目前尚无系统评价评估斑秃患者健康相关生活质量（HRQOL）的现有证据。
对斑秃患者 HRQOL 研究进行系统评价和荟萃分析。
系统检索了 1946 年至 2014 年 12 月 15 日期间 Medline、Embase、Web of Science、CINAHL、PsycINFO 和 Cochrane Library 发表的论文。采用随机效应荟萃分析对数据进行汇总。
共纳入 21 项研究，共计 2530 例成人斑秃患者。在研究中使用的 14 种不同的 HRQOL 测量方法中，皮肤病生活质量指数（DLQI；n=8）和 SF-36（n=7）最常见。确定了 3 种斑秃专用 HRQOL 工具：斑秃生活质量指数、斑秃生活质量和斑秃症状影响量表。斑秃患者平均汇总 DLQI 评分为 6.3（95%置信区间 5.6-7.1）。与年龄和性别匹配的对照组相比，SF-36 研究的荟萃分析显示，情感角色、心理健康和活力领域的 HRQOL 显著降低（P<0.001）。戴假发对 HRQOL 有积极影响，而头皮受累、焦虑和抑郁对 HRQOL 有负面影响。关于 HRQOL 与年龄、性别、婚姻状况和疾病持续时间之间的关系，研究结果存在冲突。
斑秃患者的 HRQOL 明显受损，尤其是心理健康方面。已经使用了几种通用和皮肤科专用的 HRQOL 工具，但没有验证研究证实它们在斑秃中的适用性。新开发的斑秃专用措施似乎很有前途；然而，需要更广泛地评估其有效性和可靠性。
