Journal of the American Academy of Dermatology: Original article Comorbidities in alopecia areata: A systematic review and meta-analysis

Publication date: Available online 18 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Solam Lee, Hanil Lee, Chung Hyeok Lee, Won-Soo Lee

Abstract

Background

Alopecia areata (AA) may be associated with various systemic diseases according to several studies.

Objective

To identify prevalent and incident diseases in AA patients and quantify their prevalence and odds and hazard ratio compared with those in non-AA controls.

Methods

A systematic review of the studies published before February 28, 2018 was performed using MEDLINE, Embase, Web of Science and Cochrane Library databases. Observational studies on prevalent or incident diseases in AA patients were included, whereas studies limited to pediatrics or providing only laboratory results or continuous data were excluded. Inverse variance method with random-effects model was used for meta-analyses.

Results

Eighty-seven studies were analyzed. Atopic diseases, metabolic syndrome, Helicobacter pylori infection, lupus erythematosus, iron deficiency anemia, thyroid diseases, psychiatric diseases, vitamin D deficiency, and audiologic and ophthalmic abnormalities were more prevalent in AA patients. AA patients had a higher risk of developing autoimmune diseases.

Limitations

Some diseases were investigated by an insufficient number of studies to be meta-analyzed. Meta-analysis on incident diseases was not performed owing to the limited availability on cohort studies.

Conclusion

AA is associated with various systemic and psychiatric diseases. Physicians are encouraged to evaluate and manage potential comorbid conditions to achieve better outcomes.

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