Clinico-Epidemiological Profile and Therapeutic Response of Alopecia Areata in A Tertiary Care Teaching Hospital

Background: Alopecia areata is a common disorder of hair occurring on any hair bearing site of the body and having a great psychosocial impact. Aims: To assess the demographic pattern, clinical aspects, associations and therapeutic response of AA in a tertiary care teaching hospital. Materials & methods: All patients diagnosed with alopecia areata were included in the study. With due consent, they were subjected to detailed history taking, physical examination, routine blood and radiological investigations and histopathological examination in doubtful cases. After confirmation of the diagnosis, they were subjected to two modes of therapy, oral mini pulse (OMP) steroid therapy in patients having diffuse involvement and intralesional steroid therapy in patients having localized involvement.Results: Age of onset was < 40 years in 97% of patients with a male predominance. Alopecia areata was the commonest (88%) variant noted, while alopecia totalis (1%), alopecia universalis (6%) and ophiasis pattern (5%) were also identified. Scalp (58.3%) was the commonest site involved followed by face (24%) and multiple sites (16%). Other associated autoimmune diseases were atopy (10%), lichen planus (3%) and vitiligo (2%). 72.2% of patients treated with intralesional steroid and 60% of patients treated with oral pulse steroid showed marked improvement. Conclusion: Alopecia areata is a disease of the young. Poor prognostic factors are extensive involvement, early age of onset, and positive family history in first degree relatives. Mild localized disease can be managed with intralesional steroid alone. Pulsed oral steroid, is a well tolerated mode of therapy in extensive disease.