The Dermatology Centre, Salford Royal NHS Foundation Trust, Salford, Greater Manchester, M6 8HD UK; Centre for Dermatology Research, University of Manchester, MAHSC and NIHR Manchester Biomedical Research Centre, Manchester, M13 9PL, UK.
Department of Dermatology, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, NR4 7UY, UK.
Br J Dermatol. 2022 Feb;186(2):257-265. doi: 10.1111/bjd.20628. Epub 2021 Oct 21.
There is a lack of population-based information on the disease burden and management of alopecia areata (AA).
To describe the epidemiology of AA, focusing on incidence, demographics and patterns of healthcare utilization.
Population-based cohort study of 4·16 million adults and children, using UK electronic primary care records from the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network database, 2009-2018. The incidence and point prevalence of AA were estimated. Variation in AA incidence by age, sex, deprivation, geographical distribution and ethnicity was examined. Patterns of healthcare utilization were evaluated in people with incident AA.
The AA incidence rate was 0·26 per 1000 person-years. AA point prevalence in 2018 was 0·58% in adults. AA onset peaked at age 25-29 years for both sexes, although the peak was broader in females. People of nonwhite ethnicity were more likely to present with AA, especially those of Asian ethnicity [incidence rate ratio (IRR) 3·32 (95% confidence interval 3·11-3·55)]. Higher AA incidence was associated with social deprivation [IRR most vs. least deprived quintile 1·47 (1·37-1·59)] and urban living [IRR 1·23 (1·14-1·32)]. People of higher social deprivation were less likely to be referred for specialist dermatology review.
By providing the first large-scale estimates of the incidence and point prevalence of AA, our study helps to understand the burden of AA on the population. Understanding the variation in AA onset between different population groups may give insight into the pathogenesis of AA and its management.
目前缺乏有关斑秃疾病负担和管理的基于人群的信息。
描述斑秃的流行病学，重点关注发病率、人口统计学特征和医疗保健利用模式。
这是一项基于人群的队列研究，纳入了来自英国牛津皇家全科医师学院（RCGP）研究和监测中心（RSC）网络数据库的 416 万成年人和儿童的电子初级保健记录，研究时间为 2009 年至 2018 年。估计了斑秃的发病率和时点患病率。研究还检查了斑秃发病率随年龄、性别、贫困程度、地理分布和种族的变化情况。评估了新发斑秃患者的医疗保健利用模式。
斑秃的发病率为 0.26/1000人年。2018 年成年人斑秃的时点患病率为 0.58%。男女斑秃发病高峰均出现在 25-29 岁，但女性发病高峰更宽。非白种人更易发生斑秃，尤其是亚裔人群[发病率比（IRR）3.32（95%置信区间 3.11-3.55）]。社会贫困程度越高（与最贫困五分位数相比 IRR 为 1.47（1.37-1.59））和居住在城市（IRR 为 1.23（1.14-1.32）），斑秃发病率越高。社会贫困程度较高的人群更不可能被转诊至皮肤科专家处进行评估。
本研究首次大规模估计了斑秃的发病率和时点患病率，有助于了解斑秃对人群的负担。了解不同人群斑秃发病时间的差异可能有助于深入了解斑秃的发病机制及其管理。
