Mostaghimi Arash, Napatalung Lynne, Sikirica Vanja, Winnette Randall, Xenakis Jason, Zwillich Samuel H, Gorsh Boris
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Pfizer, New York, NY, USA.
Dermatol Ther (Heidelb). 2021 Jun;11(3):867-883. doi: 10.1007/s13555-021-00512-0. Epub 2021 Mar 26.
Alopecia areata (AA) is a chronic, autoimmune disease of hair loss, which can significantly affect the emotional and psychological well-being of patients. A systematic literature review was conducted to better understand the burden of AA from the patient perspective.
Embase, MEDLINE and Cochrane databases were searched for published studies (2008-2018) reporting on assessments of health-related quality of life (HRQoL) for patients with AA. Qualitative, and quantitative data were collected.
The review included 37 studies encompassing a range of clinical outcome assessment (COA) tools. None of the COA tools were specific for AA, and only one study used the Hairdex scale, which was designed to evaluate HRQoL in patients with disorders of the hair and scalp. All studies reported substantial impact on HRQoL due to AA, both overall and in domains related to personality (i.e. temperament and character), emotions and social functioning. Acute stress was also noted, and several studies identified lack of emotional awareness (alexithymia) in 23-50% of the patients with AA.
Although it is well-established that patients with AA experience anxiety and depression, they also experience a decrease in HRQoL in many other areas, including personality, emotions, behaviors and social functioning, and these changes may be accompanied by acute stress and alexithymia. There is a need to achieve consensus on a core set of measures for AA and to develop and validate AA-specific measurement tools for use in future studies, to attain a clearer understanding of the impact of AA on patients.
PROSPERO registration number; CRD42019118646.
斑秃（AA）是一种慢性自身免疫性脱发疾病，会显著影响患者的情绪和心理健康。为了从患者角度更好地了解斑秃的负担，我们进行了一项系统的文献综述。
检索Embase、MEDLINE和Cochrane数据库，查找2008年至2018年发表的关于斑秃患者健康相关生活质量（HRQoL）评估的研究。收集定性和定量数据。
该综述纳入了37项研究，涵盖了一系列临床结局评估（COA）工具。没有一种COA工具是专门针对斑秃的，只有一项研究使用了Hairdex量表，该量表旨在评估头发和头皮疾病患者的HRQoL。所有研究均报告斑秃对HRQoL有重大影响，无论是总体影响还是在与个性（即气质和性格）、情绪和社会功能相关的领域。还提到了急性应激，几项研究发现23%-50%的斑秃患者存在情绪觉察障碍（述情障碍）。
尽管众所周知斑秃患者会经历焦虑和抑郁，但他们在许多其他方面的HRQoL也会下降，包括个性、情绪、行为和社会功能，这些变化可能伴有急性应激和述情障碍。有必要就一套核心的斑秃测量指标达成共识，并开发和验证用于未来研究的斑秃特异性测量工具，以更清楚地了解斑秃对患者的影响。
PROSPERO注册号；CRD42019118646。
