Measurement Instruments to Assess Quality of Life in Pediatric Patients With Alopecia Areata: A Systematic Review

Alopecia areata (AA) is an immune-mediated hair loss disorder that can affect various demographics, including pediatric patients, and in turn, severely impact self-esteem, peer interactions, and overall quality of life (QoL). Existing QoL tools, such as the Children's Dermatology Life Quality Index (CDLQI), address pertinent aspects of QoL including social and emotional well-being; however, they are not representative of the full scope of AA's impact. This systematic review aims to analyze existing QoL instruments in pediatric AA, evaluating their comprehensiveness and applicability, with ultimately 12 studies comprising 18 QoL instruments assessed for inclusion of the following 10 domains: emotional well-being, social functioning, psychological stress, physical symptoms, self-image and confidence, family dynamics, academic and school function, peer relationships, perceived and experienced stigma, and parental perceptions. The heterogeneity in domains included among the different QoL instruments suggests a lack of consensus on the most critical aspects of QoL to measure in pediatric AA and supports the need for new pediatric AA QoL instruments to achieve comprehensive coverage to ensure that all dimensions of a child's life affected by AA are considered.