Determining the incidence and prevalence of alopecia areata

Thanks to March 2022’s Academy Awards (and an incident involving actress Jada Pinkett Smith and her challenge with alopecia), this dermatologic condition has gotten heavy coverage in the news recently, shining light on a disorder that leads to hair loss. Alopecia areata, the proper name of the condition, may also occur in children and a better understanding of prevalence and incidence rates for the condition can help improve understading of the disease and aid in defining who may be at high risk. A multicenter investigation offers some answers.¹

Investigators looked at a multicenter cohort that included 5 children’s hospital. Data were collected for January 2009 to November 2020 through a standardized health record, PEDSnet. The cohort included patients aged younger than 18 years with a history of at least 2 clinician visits or 1 specialty dermatologist visit, that had a diagnosis code for alopecia areata.

There were 5801 patients included in the cohort. The average age in the group was 9.0 years. It skewed slightly more female (56.2%) and the race/ethnicity breakdown was: 2362 (40.7%) were White; 1348 (23.2%) were Hispanic; 1094 (18.9%) were Black; and 359 (6.2) were Asian. The investigators found that the overall prevalence of pediatric alopecia areata was 0.11%. When compared to the whole PEDSnet population, the children in the alopecia areate cohort were more often female, older, and a member of a racial/ethnicity minority group. The overall incidence rate between 2009 and 2020 was 3.6 cases per 100 000 person-years (95% CI, 13.1-14.2). Incidence rate by age had a normal distribution, with a peak at age 6 years. Girls had a rate that was 22.8% higher than boys (15.1 cases per 100 000 person-years for females vs 12.3 cases per 100 000 person-years for males). Hispanic children had the highest incidence rates(31.5 cases per 100 000 person-years).

The investigators concluded that the demographic subgroups with the highest risk were Hispanic and Asian children, who were 2 and 3 times, respectively, more likely to have a diagnosis of alopecia areata.The prevalence of 0.11% showed a doubling over the course of the time period.

Reference

1. McKenzie P, Maltenfort M, Bruckner A, et al. Evaluation of the prevalence and incidence of pediatric alopecia areata using electronic health record data. JAMA Dermatol. April 6, 2022. Epub ahead of print. doi:10.1001/jamadermatol.2022.0351