Krajewski Piotr K, Jastrząb Beata, Szepietowski Jacek C, Jankowska-Konsur Alina, Saceda Corralo David
University Center of General Dermatology and Oncodermatology, Wroclaw Medical University, Poland.
Division of Dermatology, Venereology and Clinical Immunology, Faculty of Medicine, Wroclaw University of Science and Technology, Poland.
Int J Dermatol. 2025 Nov;64(11):2029-2037. doi: 10.1111/ijd.17895. Epub 2025 Jul 2.
Alopecia areata (AA) is a nonscarring, organ-specific autoimmune disorder characterized by hair loss. Emerging evidence suggests that AA frequently coexists with other immune-mediated diseases, but the strength and consistency of these associations remain unclear. This meta-analysis aimed to systematically evaluate the prevalence and risk of immune-mediated comorbidities in patients with AA, focusing on dermatological, endocrinological, gastrointestinal, and systemic immune-mediated conditions. A comprehensive literature search was conducted in Medline, Web of Science, and Google Scholar for studies published from January 2000 through July 2024. Case-control studies reporting immune-mediated comorbidities in AA with sufficient data to calculate odds ratios (ORs) were included. Eighteen studies met the inclusion criteria, encompassing 462,945 AA patients and 11,488,192 healthy controls. Data extraction followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and study quality was assessed using the Newcastle-Ottawa Scale. The meta-analysis was performed using a random-effects model. The analysis revealed significantly increased odds of comorbid immune-mediated diseases in patients with AA, including atopic dermatitis (OR 2.63), autoimmune thyroiditis (OR 1.57), inflammatory bowel disease (OR 1.20), systemic lupus erythematosus (OR 3.28), and vitiligo (OR 6.61). The prevalence of these comorbidities ranged from 0.34% for multiple sclerosis to 38.65% for atopic disorders. These findings confirm that AA is associated with a heightened risk of various immune-mediated conditions. The strong links, particularly with vitiligo, systemic lupus erythematosus, and autoimmune thyroiditis, underscore the need for comprehensive screening and interdisciplinary management of patients with AA.
斑秃（AA）是一种非瘢痕性、器官特异性自身免疫性疾病，其特征为脱发。新出现的证据表明，斑秃常与其他免疫介导的疾病共存，但这些关联的强度和一致性仍不明确。本荟萃分析旨在系统评估斑秃患者免疫介导的合并症的患病率和风险，重点关注皮肤病学、内分泌学、胃肠道和全身性免疫介导的疾病。在Medline、科学网和谷歌学术上对2000年1月至2024年7月发表的研究进行了全面的文献检索。纳入报告斑秃患者免疫介导合并症且有足够数据计算比值比（OR）的病例对照研究。18项研究符合纳入标准，涵盖462945例斑秃患者和11488192例健康对照。数据提取遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南，并使用纽卡斯尔-渥太华量表评估研究质量。荟萃分析采用随机效应模型进行。分析显示，斑秃患者合并免疫介导疾病的几率显著增加，包括特应性皮炎（OR 2.63）、自身免疫性甲状腺炎（OR 1.57）、炎症性肠病（OR 1.20）、系统性红斑狼疮（OR 3.28）和白癜风（OR 6.61）。这些合并症的患病率从多发性硬化症的0.34%到特应性疾病的38.65%不等。这些发现证实斑秃与多种免疫介导疾病的风险增加有关。特别是与白癜风、系统性红斑狼疮和自身免疫性甲状腺炎的紧密联系，凸显了对斑秃患者进行全面筛查和跨学科管理的必要性。
