Associated comorbidities in pediatric patients with alopecia areata

Alopecia areata (AA) in children is associated with comorbidities such as atopy, vitiligo, psoriasis, and thyroid disease, but reported data are lacking. Our objective is to estimate the frequency of comorbidities present in children with AA, as well as their relationship with age of onset, specific subtype, and treatment efficacy.

We retrospectively reviewed clinical records of patients treated at the National Institute of Pediatrics between 2008 and 2018. Patients were categorized into subgroups: localized versus non-localized AA, onset in preschool age (< 7 years) versus school age (≥ 7 years), and treatment response as good (≥ 50% regrowth) versus suboptimal (< 50%). Comorbidities were classified as autoimmune, inflammatory/reactive, congenital, psychological, infectious, and neoplastic.

We included 105 patients diagnosed with AA. The most prevalent subtype was localized in 78 (74.3%) patients. Ninety-five (90%) patients had comorbidities, with allergic rhinitis (n = 12, 11.4%) and atopic dermatitis (n = 11, 10.4%) being the most frequent. Autoimmune comorbidities occurred in 16 patients (15.2%), with autoimmune thyroid disease being the most prevalent in 8 patients (7.6%). Localized AA was associated with better outcomes, shorter duration, fewer relapses, and fewer treatments, as well as inflammatory and congenital diseases.

The association of AA with atopic, autoimmune, and psychiatric comorbidities is consistent with literature reports. Our findings support intentionally seeking associated diseases in pediatric patients with AA to identify them and treat them timely.