Multivariate analysis of prognostic factors in patients with rapidly progressive alopecia areata

Background Alopecia areata (AA) is a common acquired hair disorder showing variable hair loss. Although various prognostic factors have been reported, no evident factors for determining prognosis and appropriate treatment are known. Objective To identify prognostic factors in AA patients, especially those with positive results for the hair-pull test on the first visit or with a history of rapidly progressive AA (RPAA) within 6 months prior to the first visit. Methods One thousand thirty (1030) patients diagnosed with AA at Tokyo Medical University Hospital were retrospectively examined for 3 years, and their prognosis was assessed on the basis of various indices using multivariate analysis. Results Patients with regenerated vellus hairs showed a significantly higher improvement or cure rate regardless of severity. Early onset and lengthy duration were significantly associated with lower cure, and higher relapse, rates. RPAA patients tended to show a good prognosis regardless of the treatment employed. Limitations The present study is retrospective, and treatment modalities were chosen according to clinical and social circumstances. Conclusion RPAA patients tend to show a favorable prognosis regardless of treatment modality. Furthermore, the presence of regenerated vellus hairs may indicate a good prognosis.