Muntyanu Anastasiya, Gabrielli Sofianne, Donovan Jeffrey, Gooderham Melinda, Guenther Lyn, Hanna Sameh, Lynde Charles, Prajapati Vimal H, Wiseman Marni, Netchiporouk Elena
Division of Dermatology, McGill University, Montreal, Quebec, Canada.
Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
J Eur Acad Dermatol Venereol. 2023 Jan 27. doi: 10.1111/jdv.18926.
Alopecia areata (AA) is a common inflammatory autoimmune disease of the hair which can have a significant negative impact on quality of life (QoL), mental health and productivity. The aim of this scoping review is to elucidate the burden of AA focusing on these three realms. Inclusion criteria included all original manuscripts with no restriction on study type or statistical method written in English (or having an English abstract). For QoL 40 articles were included, 85 for psychiatric comorbidities, and 9 for work/school absenteeism/presenteeism mostly consisting of cross-sectional and observational cohort studies. QoL impairment was detected in over 75% of patients and up to one-third reported extremely severe QoL impairments. Specific QoL dimensions with the greatest impact were embarrassment, social functioning, as well as shopping and/or housework. Cross-sectional studies assessing the psychological burden of adult patients with AA found that the presence of signs of anxiety and/or depression ranged from 30% to 68% and affected all age groups. Rates of work absenteeism and unemployment were significantly higher in AA patients compared to healthy controls. Up to 62% reported making major life decisions including relationships, education and career based on their AA. Additionally, the extensive camouflage techniques and time lost from work led to a strong financial burden for patients and the numerous physician visits added to the healthcare costs. The overall impact of AA stretches much further than simply being an aesthetic concern and can negatively impact every part of an individual's life. An individualized approach and effective treatments will help reduce the psychosocial consequences and distress and return patients to their normal state of health.
斑秃（AA）是一种常见的毛发炎性自身免疫性疾病，会对生活质量（QoL）、心理健康和生产力产生重大负面影响。本范围综述的目的是阐明聚焦于这三个领域的斑秃负担。纳入标准包括所有英文撰写（或有英文摘要）的原始手稿，对研究类型或统计方法无限制。关于生活质量纳入了40篇文章，关于精神共病纳入了85篇，关于工作/学校缺勤/出勤不足纳入了9篇，这些大多由横断面研究和观察性队列研究组成。超过75%的患者存在生活质量受损情况，高达三分之一的患者报告生活质量受到极其严重的损害。影响最大的特定生活质量维度是尴尬、社交功能以及购物和/或家务。评估成年斑秃患者心理负担的横断面研究发现，焦虑和/或抑郁症状的出现率在30%至68%之间，且影响所有年龄组。与健康对照组相比，斑秃患者的工作缺勤率和失业率显著更高。高达62%的患者报告基于斑秃做出了包括人际关系、教育和职业在内的重大生活决策。此外，广泛的伪装技巧和工作时间损失给患者带来了沉重的经济负担，而多次就医增加了医疗费用。斑秃的总体影响远不止是一个美观问题，还会对个人生活的方方面面产生负面影响。个性化方法和有效治疗将有助于减少心理社会后果和痛苦，使患者恢复到正常健康状态。
