TOPLINE: 

Patients with new-onset alopecia areata (AA) had a significantly higher 10-year risk of developing multiple immune-mediated inflammatory diseases (IMIDs), a study reports.

METHODOLOGY:

• Researchers used the TriNetX database to identify 26,158 children (diagnosed at age < 18 years) and 77,580 adults (diagnosed at age ≥ 18 years) with AA.
• They matched each AA cohort by age, current age, race, and relevant confounders to patients with telogen effluvium or trichotillosis.
• The study outcome was 10-year risk for IMIDs, including atopic dermatitis, autoimmune thyroiditis, celiac disease, inflammatory arthritis, psoriasis, and vitiligo. Patients with any preexisting diagnoses of these IMIDs were excluded.
• Follow-up continued until the diagnosis of an IMID, loss to follow-up, death, or 10 years post-diagnosis.

TAKEAWAY:

• Pediatric patients with AA had significantly higher 10-year risks for autoimmune thyroiditis (hazard ratio [HR], 4.21; P < .001) vitiligo (HR, 4.61; P < .001), atopic dermatitis (HR, 2.02; P < .001), psoriasis (HR, 2.87; P < .001), and inflammatory arthritis (HR, 2.11; P = .003) compared with controls.
• Compared with controls, adults with AA had greater 10-year risks for atopic dermatitis (HR, 1.61; P < .001), autoimmune thyroiditis (HR, 1.35; P < .001), psoriasis (HR, 1.52; P < .001), and vitiligo (HR, 3.53; P < .001).
• Pediatric patients with AA showed particularly higher risks for atopic dermatitis, autoimmune thyroiditis, psoriasis, and vitiligo than adults with AA.
• Females demonstrated a higher risk for atopic dermatitis and autoimmune thyroiditis than males; the risk for celiac disease was modestly increased in pediatric patients with AA (HR, 1.63; P = .008) but not in adults.

IN PRACTICE:

"This analysis demonstrates a significantly increased risk of developing several new IMIDs after AA diagnosis compared to control, most pronounced among pediatric and female patients," the study authors wrote. " These findings will help optimize patient screening and counseling among pediatric patients without a prior diagnosis of these diseases," they added.

SOURCE:

The study was led by Matthew H. Lanehart, MD, Department of Dermatology, West Virginia University School of Medicine, Morgantown, and was published online on February 27 in the Journal of the American Academy of Dermatology. 

LIMITATIONS:

The study limitations include unrecorded AA severity, potential misclassification, and limited precision in certain subgroup analyses by sex. 

DISCLOSURES:

The study had no funding source and there were no conflicts of interest declared.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.