A Large Cross-Sectional Survey Study of the Prevalence of Alopecia Areata in the United States

Purpose: Alopecia areata (AA) is an autoimmune disease characterized by the development of non-scarring alopecia. The prevalence is not well known, and estimates vary considerably with no recent estimates in the United States (US). The objective of this study was to define the current AA point preva...

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Veröffentlicht in:Clinical, cosmetic and investigational dermatology cosmetic and investigational dermatology, 2020-01, Vol.13, p.259-266
Hauptverfasser: Benigno, Michael, Anastassopoulos, Kathryn P., Mostaghimi, Arash, Udall, Margarita, Daniel, Shoshana R., Cappelleri, Joseph C., Chander, Pratibha, Wahl, Peter M., Lapthorn, Jennifer, Kauffman, Laura, Chen, Linda, Peeva, Elena
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container_issue
container_start_page 259
container_title Clinical, cosmetic and investigational dermatology
container_volume 13
creator Benigno, Michael
Anastassopoulos, Kathryn P.
Mostaghimi, Arash
Udall, Margarita
Daniel, Shoshana R.
Cappelleri, Joseph C.
Chander, Pratibha
Wahl, Peter M.
Lapthorn, Jennifer
Kauffman, Laura
Chen, Linda
Peeva, Elena
description Purpose: Alopecia areata (AA) is an autoimmune disease characterized by the development of non-scarring alopecia. The prevalence is not well known, and estimates vary considerably with no recent estimates in the United States (US). The objective of this study was to define the current AA point prevalence estimate among the general population in the US overall and by severity. Patients and Methods: We administered an online, cross-sectional survey to a representative sample of the US population. Participants self-screening as positive for AA using the Alopecia Assessment Tool (ALTO) also completed the Severity of Alopecia Tool (SALT) to measure the severity of disease as a percent of scalp hair loss. Self-reported AA participants were invited to upload photographs for adjudication of AA by 3 clinicians. Results: The average age of participants was 43 years. Approximately half of the participants (49.2%) were male, and the majority were white (77.1%) and not of Hispanic origin (93.2%). Among the 511 self-reported AA participants, 104 (20.4%) uploaded photographs for clinician evaluation. Clinician-adjudicated point prevalence of AA was 0.21% (95% CI: 0.17%, 0.25%) overall, 0.12% (95% CI: 0.09%, 0.15%) for "mild" disease (50% SALT score) with 0.04% (95% CI: 0.02%, 0.06%) for the alopecia totalis/alopecia universalis (100% SALT score) "moderate to severe" subgroup. The average SALT score was 44.4% overall, 8.8% for "mild", and 93.4% for "moderate to severe". Conclusion: This study suggests that the current AA prevalence in the US is similar to the upper estimates from the 1970s at approximately 0.21% (700,000 persons) with the current prevalence of "moderate to severe" disease at approximately 0.09% (300,000 persons). Given this prevalence and the substantial impact of AA on quality of life, the burden of AA within the US is considerable.
doi_str_mv 10.2147/CCID.S245649
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The prevalence is not well known, and estimates vary considerably with no recent estimates in the United States (US). The objective of this study was to define the current AA point prevalence estimate among the general population in the US overall and by severity. Patients and Methods: We administered an online, cross-sectional survey to a representative sample of the US population. Participants self-screening as positive for AA using the Alopecia Assessment Tool (ALTO) also completed the Severity of Alopecia Tool (SALT) to measure the severity of disease as a percent of scalp hair loss. Self-reported AA participants were invited to upload photographs for adjudication of AA by 3 clinicians. Results: The average age of participants was 43 years. Approximately half of the participants (49.2%) were male, and the majority were white (77.1%) and not of Hispanic origin (93.2%). Among the 511 self-reported AA participants, 104 (20.4%) uploaded photographs for clinician evaluation. Clinician-adjudicated point prevalence of AA was 0.21% (95% CI: 0.17%, 0.25%) overall, 0.12% (95% CI: 0.09%, 0.15%) for "mild" disease (&lt;= 50% SALT score), and 0.09% (95% CI: 0.06%, 0.11%) for "moderate to severe" disease (&gt;50% SALT score) with 0.04% (95% CI: 0.02%, 0.06%) for the alopecia totalis/alopecia universalis (100% SALT score) "moderate to severe" subgroup. The average SALT score was 44.4% overall, 8.8% for "mild", and 93.4% for "moderate to severe". Conclusion: This study suggests that the current AA prevalence in the US is similar to the upper estimates from the 1970s at approximately 0.21% (700,000 persons) with the current prevalence of "moderate to severe" disease at approximately 0.09% (300,000 persons). Given this prevalence and the substantial impact of AA on quality of life, the burden of AA within the US is considerable.</description><identifier>ISSN: 1178-7015</identifier><identifier>EISSN: 1178-7015</identifier><identifier>DOI: 10.2147/CCID.S245649</identifier><identifier>PMID: 32280257</identifier><language>eng</language><publisher>ALBANY: Dove Medical Press Ltd</publisher><subject>African Americans ; Alopecia ; alopecia assessment tool ; Autoimmune diseases ; Baldness ; Cancer therapies ; Chemotherapy ; Cross-sectional studies ; Demographics ; Dermatitis ; Dermatology ; Development and progression ; Diseases ; Epidemiology ; Hair loss ; Hispanic people ; Life Sciences &amp; Biomedicine ; Minority &amp; ethnic groups ; Original Research ; Pharmaceutical industry ; Psoriasis ; Radiation therapy ; Rosacea ; Science &amp; Technology ; severity of alopecia tool ; Skin ; Skin diseases ; Teenagers ; teledermatology ; Telemedicine ; Vitiligo</subject><ispartof>Clinical, cosmetic and investigational dermatology, 2020-01, Vol.13, p.259-266</ispartof><rights>2020 Benigno et al.</rights><rights>COPYRIGHT 2020 Dove Medical Press Limited</rights><rights>2020. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Benigno et al. 2020 Benigno et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>47</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000522992900001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c717t-5fb5c8b3034ae6542fa7aa7edef8871f376ce4d253a3b752f4c44945bf665e483</citedby><cites>FETCH-LOGICAL-c717t-5fb5c8b3034ae6542fa7aa7edef8871f376ce4d253a3b752f4c44945bf665e483</cites><orcidid>0000-0002-2868-2467 ; 0000-0002-6416-2696 ; 0000-0001-9586-0748 ; 0000-0001-7078-163X ; 0000-0003-4601-0338 ; 0000-0001-9019-3747</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7131990/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7131990/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2115,3863,27929,27930,28253,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32280257$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Benigno, Michael</creatorcontrib><creatorcontrib>Anastassopoulos, Kathryn P.</creatorcontrib><creatorcontrib>Mostaghimi, Arash</creatorcontrib><creatorcontrib>Udall, Margarita</creatorcontrib><creatorcontrib>Daniel, Shoshana R.</creatorcontrib><creatorcontrib>Cappelleri, Joseph C.</creatorcontrib><creatorcontrib>Chander, Pratibha</creatorcontrib><creatorcontrib>Wahl, Peter M.</creatorcontrib><creatorcontrib>Lapthorn, Jennifer</creatorcontrib><creatorcontrib>Kauffman, Laura</creatorcontrib><creatorcontrib>Chen, Linda</creatorcontrib><creatorcontrib>Peeva, Elena</creatorcontrib><title>A Large Cross-Sectional Survey Study of the Prevalence of Alopecia Areata in the United States</title><title>Clinical, cosmetic and investigational dermatology</title><addtitle>CLIN COSMET INV DERM</addtitle><addtitle>Clin Cosmet Investig Dermatol</addtitle><description>Purpose: Alopecia areata (AA) is an autoimmune disease characterized by the development of non-scarring alopecia. The prevalence is not well known, and estimates vary considerably with no recent estimates in the United States (US). The objective of this study was to define the current AA point prevalence estimate among the general population in the US overall and by severity. Patients and Methods: We administered an online, cross-sectional survey to a representative sample of the US population. Participants self-screening as positive for AA using the Alopecia Assessment Tool (ALTO) also completed the Severity of Alopecia Tool (SALT) to measure the severity of disease as a percent of scalp hair loss. Self-reported AA participants were invited to upload photographs for adjudication of AA by 3 clinicians. Results: The average age of participants was 43 years. Approximately half of the participants (49.2%) were male, and the majority were white (77.1%) and not of Hispanic origin (93.2%). Among the 511 self-reported AA participants, 104 (20.4%) uploaded photographs for clinician evaluation. Clinician-adjudicated point prevalence of AA was 0.21% (95% CI: 0.17%, 0.25%) overall, 0.12% (95% CI: 0.09%, 0.15%) for "mild" disease (&lt;= 50% SALT score), and 0.09% (95% CI: 0.06%, 0.11%) for "moderate to severe" disease (&gt;50% SALT score) with 0.04% (95% CI: 0.02%, 0.06%) for the alopecia totalis/alopecia universalis (100% SALT score) "moderate to severe" subgroup. The average SALT score was 44.4% overall, 8.8% for "mild", and 93.4% for "moderate to severe". Conclusion: This study suggests that the current AA prevalence in the US is similar to the upper estimates from the 1970s at approximately 0.21% (700,000 persons) with the current prevalence of "moderate to severe" disease at approximately 0.09% (300,000 persons). Given this prevalence and the substantial impact of AA on quality of life, the burden of AA within the US is considerable.</description><subject>African Americans</subject><subject>Alopecia</subject><subject>alopecia assessment tool</subject><subject>Autoimmune diseases</subject><subject>Baldness</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Cross-sectional studies</subject><subject>Demographics</subject><subject>Dermatitis</subject><subject>Dermatology</subject><subject>Development and progression</subject><subject>Diseases</subject><subject>Epidemiology</subject><subject>Hair loss</subject><subject>Hispanic people</subject><subject>Life Sciences &amp; Biomedicine</subject><subject>Minority &amp; ethnic groups</subject><subject>Original Research</subject><subject>Pharmaceutical industry</subject><subject>Psoriasis</subject><subject>Radiation therapy</subject><subject>Rosacea</subject><subject>Science &amp; Technology</subject><subject>severity of alopecia tool</subject><subject>Skin</subject><subject>Skin diseases</subject><subject>Teenagers</subject><subject>teledermatology</subject><subject>Telemedicine</subject><subject>Vitiligo</subject><issn>1178-7015</issn><issn>1178-7015</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>DOA</sourceid><recordid>eNqNk0uL2zAQgE1p6S7bvfVcDIVSaJNaL8u6FIL7CgRaSPdaIcujRMGxdiU7Jf--8ibNoxR27YPF6JtPljSTJC9RNsaI8g9lOf00nmPKciqeJJcI8WLEM8SenowvkusQVll8iGCcFM-TC4JxkWHGL5Nfk3Sm_ALS0rsQRnPQnXWtatJ57zewTeddX29TZ9JuCekPDxvVQKthiEwadwvaqnTiQXUqte09dNPaDuqYqDoIL5JnRjUBrvffq-Tmy-ef5bfR7PvXaTmZjTRHvBsxUzFdVCQjVEHOKDaKK8WhBlMUHBnCcw20xowoUnGGDdWUCsoqk-cMaEGukunOWzu1krferpXfSqesvA84v5DKd1Y3IBEgraOH86ymmJiC14yivK6AUS0Iia6PO9dtX62h1tB2XjVn0vOZ1i7lwm0kRwQJkUXB273Au7seQifXNmhoGtWC64PEpBAYYYpYRF__g65c7-P5D5TIKCJciCO1iKcvbWtcXFcPUjnJcZ7zHGf4AYqwXPBs2N34P1R8a1hb7VowNsbPtI9MOK7w5iRhCarplsE1_VBY4dz8AHg0vt-BeihSD-ZwGSiTQx_IoQ_kvg8i_ur0Ag_w36qPQLEDfkPlTNB2KOkDFhuFYSwEFkPPoNLGSo5_VLq-7WLqu8enkj804x0_</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Benigno, Michael</creator><creator>Anastassopoulos, Kathryn P.</creator><creator>Mostaghimi, Arash</creator><creator>Udall, Margarita</creator><creator>Daniel, Shoshana R.</creator><creator>Cappelleri, Joseph C.</creator><creator>Chander, Pratibha</creator><creator>Wahl, Peter M.</creator><creator>Lapthorn, Jennifer</creator><creator>Kauffman, Laura</creator><creator>Chen, Linda</creator><creator>Peeva, Elena</creator><general>Dove Medical Press Ltd</general><general>Dove Medical Press Limited</general><general>Taylor &amp; Francis Ltd</general><general>Dove</general><general>Dove Medical Press</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>KB0</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-2868-2467</orcidid><orcidid>https://orcid.org/0000-0002-6416-2696</orcidid><orcidid>https://orcid.org/0000-0001-9586-0748</orcidid><orcidid>https://orcid.org/0000-0001-7078-163X</orcidid><orcidid>https://orcid.org/0000-0003-4601-0338</orcidid><orcidid>https://orcid.org/0000-0001-9019-3747</orcidid></search><sort><creationdate>20200101</creationdate><title>A Large Cross-Sectional Survey Study of the Prevalence of Alopecia Areata in the United States</title><author>Benigno, Michael ; Anastassopoulos, Kathryn P. ; Mostaghimi, Arash ; Udall, Margarita ; Daniel, Shoshana R. ; Cappelleri, Joseph C. ; Chander, Pratibha ; Wahl, Peter M. ; Lapthorn, Jennifer ; Kauffman, Laura ; Chen, Linda ; Peeva, Elena</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c717t-5fb5c8b3034ae6542fa7aa7edef8871f376ce4d253a3b752f4c44945bf665e483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>African Americans</topic><topic>Alopecia</topic><topic>alopecia assessment tool</topic><topic>Autoimmune diseases</topic><topic>Baldness</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Cross-sectional studies</topic><topic>Demographics</topic><topic>Dermatitis</topic><topic>Dermatology</topic><topic>Development and progression</topic><topic>Diseases</topic><topic>Epidemiology</topic><topic>Hair loss</topic><topic>Hispanic people</topic><topic>Life Sciences &amp; Biomedicine</topic><topic>Minority &amp; ethnic groups</topic><topic>Original Research</topic><topic>Pharmaceutical industry</topic><topic>Psoriasis</topic><topic>Radiation therapy</topic><topic>Rosacea</topic><topic>Science &amp; Technology</topic><topic>severity of alopecia tool</topic><topic>Skin</topic><topic>Skin diseases</topic><topic>Teenagers</topic><topic>teledermatology</topic><topic>Telemedicine</topic><topic>Vitiligo</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Benigno, Michael</creatorcontrib><creatorcontrib>Anastassopoulos, Kathryn P.</creatorcontrib><creatorcontrib>Mostaghimi, Arash</creatorcontrib><creatorcontrib>Udall, Margarita</creatorcontrib><creatorcontrib>Daniel, Shoshana R.</creatorcontrib><creatorcontrib>Cappelleri, Joseph C.</creatorcontrib><creatorcontrib>Chander, Pratibha</creatorcontrib><creatorcontrib>Wahl, Peter M.</creatorcontrib><creatorcontrib>Lapthorn, Jennifer</creatorcontrib><creatorcontrib>Kauffman, Laura</creatorcontrib><creatorcontrib>Chen, Linda</creatorcontrib><creatorcontrib>Peeva, Elena</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; 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Allied Health Premium</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Clinical, cosmetic and investigational dermatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Benigno, Michael</au><au>Anastassopoulos, Kathryn P.</au><au>Mostaghimi, Arash</au><au>Udall, Margarita</au><au>Daniel, Shoshana R.</au><au>Cappelleri, Joseph C.</au><au>Chander, Pratibha</au><au>Wahl, Peter M.</au><au>Lapthorn, Jennifer</au><au>Kauffman, Laura</au><au>Chen, Linda</au><au>Peeva, Elena</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Large Cross-Sectional Survey Study of the Prevalence of Alopecia Areata in the United States</atitle><jtitle>Clinical, cosmetic and investigational dermatology</jtitle><stitle>CLIN COSMET INV DERM</stitle><addtitle>Clin Cosmet Investig Dermatol</addtitle><date>2020-01-01</date><risdate>2020</risdate><volume>13</volume><spage>259</spage><epage>266</epage><pages>259-266</pages><issn>1178-7015</issn><eissn>1178-7015</eissn><abstract>Purpose: Alopecia areata (AA) is an autoimmune disease characterized by the development of non-scarring alopecia. The prevalence is not well known, and estimates vary considerably with no recent estimates in the United States (US). The objective of this study was to define the current AA point prevalence estimate among the general population in the US overall and by severity. Patients and Methods: We administered an online, cross-sectional survey to a representative sample of the US population. Participants self-screening as positive for AA using the Alopecia Assessment Tool (ALTO) also completed the Severity of Alopecia Tool (SALT) to measure the severity of disease as a percent of scalp hair loss. Self-reported AA participants were invited to upload photographs for adjudication of AA by 3 clinicians. Results: The average age of participants was 43 years. Approximately half of the participants (49.2%) were male, and the majority were white (77.1%) and not of Hispanic origin (93.2%). Among the 511 self-reported AA participants, 104 (20.4%) uploaded photographs for clinician evaluation. Clinician-adjudicated point prevalence of AA was 0.21% (95% CI: 0.17%, 0.25%) overall, 0.12% (95% CI: 0.09%, 0.15%) for "mild" disease (&lt;= 50% SALT score), and 0.09% (95% CI: 0.06%, 0.11%) for "moderate to severe" disease (&gt;50% SALT score) with 0.04% (95% CI: 0.02%, 0.06%) for the alopecia totalis/alopecia universalis (100% SALT score) "moderate to severe" subgroup. The average SALT score was 44.4% overall, 8.8% for "mild", and 93.4% for "moderate to severe". Conclusion: This study suggests that the current AA prevalence in the US is similar to the upper estimates from the 1970s at approximately 0.21% (700,000 persons) with the current prevalence of "moderate to severe" disease at approximately 0.09% (300,000 persons). Given this prevalence and the substantial impact of AA on quality of life, the burden of AA within the US is considerable.</abstract><cop>ALBANY</cop><pub>Dove Medical Press Ltd</pub><pmid>32280257</pmid><doi>10.2147/CCID.S245649</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2868-2467</orcidid><orcidid>https://orcid.org/0000-0002-6416-2696</orcidid><orcidid>https://orcid.org/0000-0001-9586-0748</orcidid><orcidid>https://orcid.org/0000-0001-7078-163X</orcidid><orcidid>https://orcid.org/0000-0003-4601-0338</orcidid><orcidid>https://orcid.org/0000-0001-9019-3747</orcidid><oa>free_for_read</oa></addata></record>
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source DOAJ Directory of Open Access Journals; Dove Press Free; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" />; Access via Taylor & Francis (Open Access Collection); PubMed Central
subjects African Americans
Alopecia
alopecia assessment tool
Autoimmune diseases
Baldness
Cancer therapies
Chemotherapy
Cross-sectional studies
Demographics
Dermatitis
Dermatology
Development and progression
Diseases
Epidemiology
Hair loss
Hispanic people
Life Sciences & Biomedicine
Minority & ethnic groups
Original Research
Pharmaceutical industry
Psoriasis
Radiation therapy
Rosacea
Science & Technology
severity of alopecia tool
Skin
Skin diseases
Teenagers
teledermatology
Telemedicine
Vitiligo
title A Large Cross-Sectional Survey Study of the Prevalence of Alopecia Areata in the United States
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