Safavi K H, Muller S A, Suman V J, Moshell A N, Melton L J
Section of Clinical Epidemiology, Mayo Clinic Rochester, MN 55905, USA.
Mayo Clin Proc. 1995 Jul;70(7):628-33. doi: 10.4065/70.7.628.
To assess the incidence and natural history of alopecia areata (AA) among unselected patients from a community.
We conducted a retrospective population-based descriptive study of AA among residents of Olmsted County, Minnesota, for the period from 1975 through 1989.
After identifying 292 Olmsted County residents first diagnosed with AA during the 15-year study period, we reviewed their complete (inpatient and outpatient) medical records in the community and statistically analyzed the effects of gender and age-group.
The overall incidence of AA was 20.2 per 100,000 person-years and did not change with time. Rates were similar in the two genders and over all ages, and lifetime risk was estimated at 1.7%. Eighty-seven percent of patients were examined by a dermatologist who diagnosed AA, and 29% of cases were confirmed by biopsy. Most patients had mild or moderate disease, but alopecia totalis or universalis developed at some point during the clinical course in 21 patients.
This study of the incidence and natural history of AA in a community shows that this disorder is fairly common and can be seen at all ages. Although spontaneous resolution is expected in most patients, a small but significant proportion of cases (probably approximately 7%) may evolve into severe and chronic hair loss, which may be psychosocially devastating for affected persons.
评估社区中未经挑选的斑秃（AA）患者的发病率及自然病程。
我们对明尼苏达州奥尔姆斯特德县1975年至1989年期间居民中的斑秃进行了一项基于人群的回顾性描述性研究。
在确定了292名在15年研究期间首次被诊断为斑秃的奥尔姆斯特德县居民后，我们查阅了他们在社区的完整（住院和门诊）病历，并对性别和年龄组的影响进行了统计分析。
斑秃的总体发病率为每10万人年20.2例，且不随时间变化。两性和各年龄段的发病率相似，终生风险估计为1.7%。87%的患者由诊断为斑秃的皮肤科医生进行了检查，29%的病例经活检确诊。大多数患者病情为轻度或中度，但在临床过程中的某个时间点，21例患者出现了全秃或普秃。
这项对社区斑秃发病率及自然病程的研究表明，这种疾病相当常见且各年龄段均可出现。尽管大多数患者有望自发缓解，但一小部分但比例显著的病例（可能约为7%）可能会发展为严重的慢性脱发，这对患者的心理社会层面可能造成极大破坏。
