Sanchez Katherine, Biba Ursula, Gregoire Samantha, Mesinkovska Natasha Atanaskova, Waldman Monique Margaret, Anderson Lisa, Mostaghimi Arash
Department of Dermatology, Brigham and Women's Hospital, Boston, MA, USA.
Lake Erie College of Osteopathic Medicine, Erie, PA, USA.
Skin Appendage Disord. 2025 Apr 17:1-6. doi: 10.1159/000545861.
Severity of alopecia areata (AA) has been commonly defined by clinician assessment of scalp hair loss. Our aim was to characterize patient-reported factors beyond scalp hair loss that contribute to AA severity while modifying for socioeconomic factors.
Patients with AA were recruited to take a survey. Multivariable linear regression was performed to evaluate lifetime AA severity while adjusting for socioeconomic variables, current AA severity at the time of survey, and patient-reported disease burden.
Patient-reported AA severity was associated with scalp hair loss (OR: 4.19, 95% CI: [1.35-13], = 0.013), facial hair loss (OR: 3.55, 95% CI: [1.75-7.21], < 0.001), increased financial burden (OR: 2.41, 95% CI: [1.21-4.8], = 0.013), and greater emotional burden (OR: 2.96, 95% CI: [1.48-5.93], = 0.002), while presence of comorbidities were linked to less severe AA (OR: 0.38, 95% CI: [0.17-0.84], = 0.017).
Survey population was homogeneous and may not reflect the general community with AA. Self-reported data may introduce recency or recall bias. Scalp and facial hair loss, along with emotional and financial burdens, correlate with increased patient-reported AA severity. This suggests factors beyond scalp hair loss should be considered when assessing AA severity.
斑秃（AA）的严重程度通常由临床医生对头皮脱发情况的评估来定义。我们的目的是确定除头皮脱发外，对AA严重程度有影响的患者报告因素，并对社会经济因素进行校正。
招募AA患者进行一项调查。进行多变量线性回归，以评估终生AA严重程度，同时校正社会经济变量、调查时的当前AA严重程度以及患者报告的疾病负担。
患者报告的AA严重程度与头皮脱发（比值比：4.19，95%置信区间：[1.35 - 13]，P = 0.013）、面部脱发（比值比：3.55，95%置信区间：[1.75 - 7.21]，P < 0.001）、经济负担增加（比值比：2.41，95%置信区间：[1.21 - 4.8]，P = 0.013）以及更大的情感负担（比值比：2.96，95%置信区间：[1.48 - 5.93]，P = 0.002）相关，而合并症的存在与AA严重程度较轻相关（比值比：0.38，95%置信区间：[0.17 - 0.84]，P = 0.017）。
调查人群具有同质性，可能无法反映AA患者的总体情况。自我报告的数据可能会引入近期偏差或回忆偏差。头皮和面部脱发，以及情感和经济负担，与患者报告的AA严重程度增加相关。这表明在评估AA严重程度时，应考虑头皮脱发以外的因素。
