BACKGROUND: Research has indicated that the disease burden of alopecia areata (AA) in China exceeds the global average. Therefore, accurate and updated epidemiological information is crucial for policymakers. In this study, we aimed to comprehensively assess the disease burden of AA in China. METHODS: The following four key indicators were utilized: the prevalence of cases; disability-adjusted life-years (DALYs); the age-standardized prevalence rate (ASPR); and the age-standardized DALY rate (ASDR) of AA according to the Global Burden of Disease (GBD) study 2021. We analyzed the epidemiological burden of AA in China during 2021, examined changes between 1990 and 2021, and performed a Bayesian age-period-cohort analysis to predict trends over the course of the next decade (2022-2030). Additionally, a Gaussian process regression model was applied to estimate the relationship between the gross domestic product (GDP) and the ASPR and ASDR of AA at the provincial level between 1992 and 2021. RESULTS: In 2021, the estimated number of patients with AA in China was approximately 3.49 million (95% uncertainty interval [UI], 3.37-3.62 million); of these patients, 1.20 million (95% UI, 1.16-1.25 million) were male and 2.29 million (95% UI, 2.20-2.37 million) were female. This large number of patients with AA resulted in a total of 114,431.25 DALYs (95% UI, 74,780.27-160,318.96 DALYs). Additionally, the ASPR and ASDR were 224.61 per 100,000 population (95% UI, 216.73-232.65 per 100,000 population) and 7.41 per 100,000 population (95% UI, 4.85-10.44 per 100,000 population), respectively; both of these rates were higher than the global averages. The most affected demographic groups were young and female individuals 25-39 years of age. Slight regional disparities were observed, with the northern and central regions of China bearing comparatively higher burdens. Between 1990 and 2021, the health loss and disease burden caused by AA in China remained relatively stable. The ASPR and ASDR of AA increased with the GDP when the annual GDP was less than 2 trillion Chinese yuan; however, a downward trend was observed as the GDP surpassed 2 trillion Chinese yuan. A slight upward trend in the disease burden of AA in China is predicted to occur over the next decade. CONCLUSIONS AA continues to be a public health concern in China that shows no signs of declining. Targeted efforts for young individuals and females are necessary because they experience a disproportionately high burden of AA.
Humans ; China/epidemiology* ; Alopecia Areata/epidemiology* ; Global Burden of Disease ; Female ; Male ; Adult ; Disability-Adjusted Life Years ; Middle Aged ; Prevalence ; Adolescent ; Young Adult ; Bayes Theorem ; Child ; Quality-Adjusted Life Years ; Child, Preschool

BACKGROUND: Alopecia areata is the most common cause of localized, nonscarring alopecia. Unfortunately, there are few data regarding clinical features and epidemiology of alopecia areata in Korean patients, and its clinical course and treatment response rates are unpredictable. OBJECTIVE: This study strived to investigate the differences in clinical profiles according to disease severity and to determine risk factors for severe alopecia areata. METHODS: A total of 1,137 patients from 2006 to 2015 were analyzed retrospectively. Patients were subdivided into two groups: mild-to-moderate and severe alopecia areata. The groups were compared on the basis of age of onset, duration, sex, family history, comorbid disorders including autoimmune diseases, nail changes, and laboratory test results. RESULTS: Eight hundred eighty-three patients were in the mild-to-moderate alopecia areata group and 254 patients were in the severe group. Average onset age was 30.77±17.66 years and 30.60±16.75 years in the mild-to-moderate and severe groups, respectively. Disease duration was statistically longer in the severe group. Male sex, nail changes, and thyroid diseases were more common in the severe group. Hypertension, diabetes mellitus, dyslipidemia, atopic dermatitis, and family history did not differ between groups. Of the serologic values, only alkaline phosphatase was considerably differing between groups. Male sex, presence of nail changes, and disease duration greater than one year were identified as significant risk factors for severe alopecia areata. CONCLUSION: This is the largest case analysis in Korean patients with alopecia areata. Clinical profiles stratified by disease severity warrant further study.
Age of Onset ; Alkaline Phosphatase ; Alopecia Areata* ; Alopecia* ; Autoimmune Diseases ; Dermatitis, Atopic ; Diabetes Mellitus ; Dyslipidemias ; Epidemiology ; Humans ; Hypertension ; Male ; Retrospective Studies ; Risk Factors ; Thyroid Diseases

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: Clinical features of alopecia areata in children are diverse and unpredictable. Epidemiology of alopecia areata in adults is relatively well documented, but not in children. OBJECTIVE: We performed a clinical and psychological study for alopecia areata in children in order to evaluate the clinical characteristics and psychosomatic dynamics. METHODS: A clinical and psychological study of 161 patients(alopecia areata(AA) type 134 patients, alopecia totalis(AT) type 15 patients, alopecia universalis(AU) type 12 patients) were performed with alopecia under 15 years old from April 1995 to December 2000 at the Alopecia Clinic, Department of Dermatology, College of Medicine, Chung Ang University. RESULTS: Average age of alopecia areata in children was 7.8 years, and 55.9% were primary school students. The most common type was AA(83.2%). Previous episodes of alopecia areata were observed in 11.8%, and family history of alopecia areata was observed in 6.8%(11/161). The most common associated disease was atopic dermatitis(45.3%). The eldest sibling or the children with deficient parent-child relationship were a more vulnerable group. On the neuropsychiatric consult, problematic cases were observed in 68.3%(110/161), and neurotic children was the most common problem among them 42.7%(47/110). Efficacy of treatment in the group treated with an intralesional injection of triamcinolone acetonide revealed no significant differences from the group treated with DPCP. CONCLUSIONS: From the above results it is concluded that alopecia areata in children was predominantly developed in primary school students. Atopic dermatitis is the most common associated disease. The relationship between parents and children is an important factor in the development of the disease or may contribute as an aggravating factor.
Adolescent ; Adult ; Alopecia Areata* ; Alopecia* ; Child* ; Dermatitis, Atopic ; Dermatology ; Epidemiology ; Humans ; Injections, Intralesional ; Parent-Child Relations ; Parents ; Siblings ; Triamcinolone Acetonide

BACKGROUND: There has been no statistical study of dermatoses in the Suwon area and southern area of Kyonggi province which has been rapidly developing in the last 7 years. OBJECTIVE AND METHODS: We evaluated the recent distributions of dermatoses in the Suwon area and southern area of Kyonggi and compared them with the previous reports of other provinces of Korea. Fifty two thousand, one hundred fifty three new outpatients who visited the Ajou University Hospital from 1995 to 2001 were analysed statistically. RESULTS: The study results are summarized as follows: Among the 52, 153 outpatients, the total number of male patients were 24, 005(46.0%) and female patients were 28, 148(54.0%). The frequency of age groups are as follows; the age groups were the 3rd decade(22.0%), 4th decade(20.4%), 1st decade(18.7%), 5th decade(11.5%), 2nd decade(11.1%), 6th(8.5%), 7th(5.4%), 8th and above(2.4%). The distributions of dermatoses as disease groups were eczema(28.6%), dermatophytosis(8.7%), erythema urticaria and drug eruption(8.1%), disease of skin appendages(7.9%), viral infection(7.3%), etc. Those dermatoses which demonstrated a tendency to increase annually were seborrheic dermatitis, hyperpigmentary disorders, verruca, and alopecia areata. The incidence of dermatophytosis, in particular, decreased during the study period. Seasonal distribution showed that those diseases occurring the most frequently during the summer were dermatophytosis, allergic contact dermatitis, urticaria, verruca, and vitiligo. The incidence of atopic dermatitis and nevocellular nevi increased during the winter season. Acne vulgaris was the disease occurring frequently during summer and winter. Sexual distribution of dermatoses showed that hyperpigmentary disorder, nevocellular nevi, benign epidermal tumor, acne, allergic contact dermatitis, and irritant contact dermatitis were more frequent in females, and dermatophytosis, seborrheic dermatitis, alopecia were more frequent in males. Age distribution was as follows; atopic dermatitis, vitiligo and verruca was the most frequent in the 1st decade. Acne vulgaria was the most frequent in the 2nd decade and 3rd decade. Hyperpigmentary disorder and seborrheic dermatitis were the most frequent in the 4th decade. Hyperpigmentary disorder was the most frequent in the 5th decade and herpes zoster in 6th, 7th and 8th decade and above. CONCLUSION: In contrast to an earlier published report from Seoul, the infectious dermatoses, especially parasitic infestation, showed a tendency to decrease and nevocellular nevi, hyperpigmentary disorder and alopecia showed a tendency to increase. The distribution pattern of the skin disease did not differ from other provinces of Korea in general.
Acne Vulgaris ; Age Distribution ; Alopecia ; Alopecia Areata ; Dermatitis, Allergic Contact ; Dermatitis, Atopic ; Dermatitis, Contact ; Dermatitis, Seborrheic ; Epidemiology ; Erythema ; Female ; Gyeonggi-do* ; Herpes Zoster ; Humans ; Incidence ; Korea ; Male ; Nevus ; Outpatients ; Seasons ; Seoul ; Skin ; Skin Diseases* ; Statistics as Topic* ; Tinea ; Urticaria ; Vitiligo ; Warts