Lu Ying-Yi, Wu Ming-Kung, Lu Chun-Ching, Wang Wei-Ting, Wu Chieh-Hsin
Department of Dermatology, Kaohsiung Veterans General Hospital; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Niaosong Dist, Kaohsiung, Taiwan.
Indian J Dermatol Venereol Leprol. 2025 May-Jun;91(3):294-299. doi: 10.25259/IJDVL_1215_2023.
Background Alopecia areata (AA), a disorder of non-scarring hair loss with a variable relapsing and remitting course, is a common autoimmune disease in children. Although it often presents as several focal small patchy bald lesions, early onset AA can lead to a total loss of scalp hair, even body hairs, a severe subtype. Atopic diseases are common concurrent disorders in AA, especially among those with early onset severe type of hair loss. Whether atopic diseases increase the risk of AA in the paediatric population of Taiwan, remains unclear. Objective To identify if atopic diseases increase the risk of AA among pre-teens and teenagers in Taiwan. Methods From Taiwan National Health Insurance Database 2010, we used the claims data to clarify the risk of AA in pre-teens and teenagers with atopic diseases (atopic dermatitis, allergic conjunctivitis, asthma, allergic rhinitis and food allergy) as compared to the general population. Cox proportional hazards model yielded hazard ratios (HRs) to address the impact of atopic diseases, sex and age on AA risk after adjusting for covariates and subsequent stratified analyses. Results Overall, 21,070 children (10,535 patients with atopic diseases and 10,535 normal cohort) aged over nine years were recruited. During a follow-up of 15 years, 39 (0.37%) cases were identified to have AA in the atopic diseases group, while 11 (0.10%) had developed AA in the normal cohort. As compared with the normal population, the paediatric population with atopic diseases had a 9.66-fold higher risk of developing AA. The risk was greater for boys and increased with advanced age. In the atopic diseases group, pre-teens and teenagers with food allergies and Sjogren's syndrome were more likely to have AA. Limitations Only one ethnic group. Conclusion All atopic diseases enhanced the risk of developing AA in Taiwan pre-teens and teenagers. Children with atopic diseases should be monitored to look for the development of AA.
斑秃（AA）是一种非瘢痕性脱发疾病，病程呈复发和缓解交替，是儿童常见的自身免疫性疾病。虽然它通常表现为几个局灶性小片状秃发皮损，但早发性AA可导致头皮毛发甚至身体毛发全部脱落，这是一种严重的亚型。特应性疾病是AA常见的并发疾病，尤其是在早发性严重脱发类型的患者中。台湾儿童人群中特应性疾病是否会增加患AA的风险尚不清楚。
确定特应性疾病是否会增加台湾青少年患AA的风险。
从2010年台湾国民健康保险数据库中，我们使用理赔数据来阐明患有特应性疾病（特应性皮炎、过敏性结膜炎、哮喘、过敏性鼻炎和食物过敏）的青少年与普通人群相比患AA的风险。Cox比例风险模型得出风险比（HRs），以在调整协变量后解决特应性疾病、性别和年龄对AA风险的影响，并进行后续分层分析。
总体而言，招募了21070名9岁以上儿童（10535名患有特应性疾病的患者和10535名正常队列）。在15年的随访期间，特应性疾病组中有39例（0.37%）被确诊患有AA，而正常队列中有11例（0.10%）患AA。与正常人群相比，患有特应性疾病的儿童患AA的风险高9.66倍。男孩的风险更大，且随着年龄增长而增加。在特应性疾病组中，患有食物过敏和干燥综合征的青少年更易患AA。
仅一个种族群体。
在台湾青少年中，所有特应性疾病都会增加患AA的风险。应监测患有特应性疾病的儿童，以观察是否会发生AA。
