Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Applied Clinical Research Center, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
JAMA Dermatol. 2022 May 1;158(5):547-551. doi: 10.1001/jamadermatol.2022.0351.
Pediatric alopecia areata (AA) prevalence and incidence data are key to understanding the natural history of this medical disease.
To determine the prevalence and incidence of AA in a pediatric population across time, age, sex, race and ethnicity, and geographic areas within the US.
DESIGN, SETTING, AND PARTICIPANTS: In this multicenter cohort study conducted among 5 children's hospitals, data (January 2009 to November 2020) were collected from a standardized electronic health record (PEDSnet database, version 4.0) to evaluate the incidence and prevalence of pediatric AA. The study cohort included patients younger than 18 years with at least 2 physician visits during which a diagnosis code for AA was recorded, or 1 dermatologist specialty visit for which AA was recorded.
The prevalence denominator population comprised 5 409 919 patients. The incidence denominator population was 2 896 241. We identified 5801 children for inclusion in the AA cohort, and 2398 (41.3%) had 12 months or more of follow-up and were included in the incidence analysis.
Of 5801 patients in the AA cohort, the mean (SD) age was 9.0 (4.5) years, 3259 (56.2%) were female, 359 (6.2) were Asian, 1094 (18.9%) were Black, 1348 (23.2%) were Hispanic, and 2362 (40.7%) were White. The overall prevalence of pediatric AA was 0.11%, and the participants in the AA cohort were more often older, female, and members of a racial and ethnic minority group than the full PEDSnet population. The 11-year overall incidence rate of pediatric AA between 2009 and 2020 was 13.6 cases per 100 000 person-years (95% CI, 13.1-14.2). The incidence rate by age was normally distributed and peaked at age 6 years. Rates were 22.8% higher in female patients than male patients (15.1 cases per 100 000 person-years for females vs 12.3 cases per 100 000 person-years for males). Additionally, incidence rates were highest among Hispanic children (31.5 cases per 100 000 person-years).
This cohort study examined the prevalence and incidence rates of pediatric AA in the US across time, age, sex, race and ethnicity, and region from 2009 to 2020, finding a prevalence of 0.11% (doubling during the last decade) and incidence rate of 13.6 cases per 100 000 person-years. Additionally, the results identified Asian and Hispanic children as high-risk demographic subgroups who were shown to be 2 and 3 times more likely, respectively, to receive a diagnosis of AA.
儿科斑秃（AA）的患病率和发病率数据是了解这种医学疾病自然史的关键。
确定美国儿科人群中 AA 的患病率和发病率随时间、年龄、性别、种族和民族以及地理位置的变化情况。
设计、地点和参与者：在这项在五家儿童医院进行的多中心队列研究中，从标准化电子健康记录（PEDSnet 数据库，版本 4.0）中收集了数据（2009 年 1 月至 2020 年 11 月），以评估儿科 AA 的发病率和患病率。研究队列包括年龄小于 18 岁的患者，这些患者在至少两次就诊期间记录了 AA 的诊断代码，或在一次皮肤科专家就诊期间记录了 AA。
患病率分母人群由 5409919 名患者组成。发病率分母人群为 2896241 人。我们确定了 5801 名符合 AA 队列纳入标准的儿童，其中 2398 名（41.3%）有 12 个月或更长时间的随访，并纳入了发病率分析。
在 AA 队列的 5801 名患者中，平均（SD）年龄为 9.0（4.5）岁，3259 名（56.2%）为女性，359 名（6.2%）为亚洲人，1094 名（18.9%）为黑人，1348 名（23.2%）为西班牙裔，2362 名（40.7%）为白人。儿科 AA 的总体患病率为 0.11%，与 PEDSnet 全体人群相比，AA 队列的参与者年龄更大、女性更多，且更可能属于少数种族和民族群体。2009 年至 2020 年间，儿科 AA 的 11 年总体发病率为每 10 万人年 13.6 例（95%CI，13.1-14.2）。按年龄计算的发病率呈正态分布，峰值出现在 6 岁。女性患者的发病率比男性患者高 22.8%（女性每 10 万人年 15.1 例，男性每 10 万人年 12.3 例）。此外，西班牙裔儿童的发病率最高（每 10 万人年 31.5 例）。
本队列研究在 2009 年至 2020 年期间，按时间、年龄、性别、种族和民族以及地区，在美国对儿科 AA 的患病率和发病率进行了调查，结果显示患病率为 0.11%（过去十年翻了一番），发病率为每 10 万人年 13.6 例。此外，研究结果还发现亚洲和西班牙裔儿童是高危人群，他们分别被诊断出患有 AA 的可能性是其他儿童的 2 倍和 3 倍。
