Alopecia totalis (AT) and alopecia universalis (AU), severe forms of alopecia areata (AA), show distinguishable clinical characteristics from those of patch AA. In this study, we investigated the clinical characteristics of AT/AU according to the onset age. Based on the onset age around adolescence (< or > or = 13 yr), 108 patients were classified in an early-onset group and the other 179 patients in a late-onset group. We found that more patients in the early-onset group had a family history of AA, nail dystrophy, and history of atopic dermatitis than those in the late-onset group. These clinical differences were more prominent in patients with AU than in those with AT. In addition, significantly more patients with concomitant medical disorders, especially allergic diseases were found in the early-onset group (45.8%) than in the late-onset group (31.2%). All treatment modalities failed to show any association with the present hair condition of patients. In the early-onset group, patients with AU or a family history of AA showed worse prognosis, whereas this trend was not observed in the late-onset group. Systemic evaluations might be needed in early-onset patients due to the higher incidence of comorbid diseases. It is suggested that patients with AU or family history of AA make worse progress in the early-onset group than in the late-onset group.
Adolescent ; Adult ; Age of Onset ; Alopecia/diagnosis/epidemiology ; Alopecia Areata/*diagnosis/epidemiology ; Child ; Child, Preschool ; Dermatitis, Atopic/diagnosis ; Family Health ; Female ; Humans ; Infant ; Male ; Middle Aged ; Nail Diseases/diagnosis ; Prognosis ; Young Adult

BACKGROUND: To date, numerous studies have investigated the epidemiology and clinical characteristics of male pattern hair loss (MPHL). OBJECTIVE: The purpose of this study was to evaluate a large number of long-term MPHL patients and to compare them to shorter term ones from other studies. METHODS: We retrospectively reviewed charts of patients diagnosed with MPHL during a 10-year period at the alopecia clinic at the Department of Dermatology of Myongji Hospital. RESULTS: Among 3,549 alopecia patients who had visited the hospital's alopecia clinic, 1,360 were patients demonstrating MPHL (38.3%). The most frequent age group was patients in their 20's (30.1%) followed by those in their 30's (28.2%), 40's (17.2%), 50's (9.9%), and teenagers (8.9%). There were 599 MPHL patients (44.0%) with a paternal familial predisposition, 182 (13.4%) with a maternal familial predisposition, and 118 (8.7%) with familial predisposition on maternal and paternal sides. MPHL was classified based on the Norwood-Hamilton classification: type 2 (20.0%), type 3v (19.4%), and type 3a (16.3%) were the most frequent. Abnormalities in total serum cholesterol were found in 15.1% patients and triglycerides in 36.1% of patients. The most common comorbidity was seborrheic dermatitis, followed by hypertension, hyperlipidemia, diabetes mellitus, and gastrointestinal diseases. CONCLUSION: This study demonstrated that the period of MPHL diagnosis and treatment becomes earlier in age and milder regarding MPHL type, which may be due to early puberty in teenagers.
Adolescent ; Alopecia ; Cholesterol ; Classification ; Comorbidity ; Dermatitis, Seborrheic ; Dermatology ; Diabetes Mellitus ; Diagnosis ; Epidemiology ; Gastrointestinal Diseases ; Hair* ; Humans ; Hyperlipidemias ; Hypertension ; Male* ; Puberty ; Retrospective Studies ; Triglycerides