Is atopy and autoimmunity more prevalent in patients with alopecia areata? A comparative study

OBJECTIVE: We aimed to determine whether there was a difference between adult and paediatric alopecia areata patients with respect to the severity and pattern of the disease, nail changes and personal and family history of autoimmune diseases and also in comparison with controls. METHODS: Two groups were included: patients with onset of alopecia before the age of ≤18 years and >18 years. The total number of the patients were 124. The control group was comprised of 114 age- and gender-matched patients. RESULTS: There were 81 adults and 43 children. No statistically significant difference was present between disease severity and gender, age, personal and family history of autoimmune disease in the adult and paediatric group (P > 0.5). Thirteen adults with scalp involvement had nail changes. 61.5% had mild and 38.46% had severe disease (P > 0.5). Of the 43 paediatric patients, 10 patients had nail changes. Severe alopecia was present in 40% of patients with nail changes; however, 9.1% had severe alopecia in patients without nail changes (P = 0.04). There was no statistical significance in patients with and without familial autoimmune diseases when compared with pattern and severity of the diseases between the two groups. CONCLUSION: The frequencies of autoimmune and atopic diseases were not different between adult and paediatric patients and the control group. We did not find a statistically significance between disease severity and personal and family history of autoimmune disease in the two groups. Disease severity was not related to nail changes in the adult group. However, severe alopecia areata was more prevalent in children with nail changes. Furthermore, ophiasis pattern was more prevalent in the paediatric group with nail changes compared with the adult group.