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. 2023 May;315(4):807-813.
doi: 10.1007/s00403-022-02444-x. Epub 2022 Nov 1.

Immune-mediated diseases and subsequent risk of alopecia areata in a prospective study of US women

Isabelle H Moseley  1 , Jordan M Thompson  2 , Elisabeth A George  1 , Sara D Ragi  1 , Jae H Kang  3 , Anthony M Reginato  2   4 , Abrar Qureshi  2   5 , Eunyoung Cho  6   7   8
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Immune-mediated diseases and subsequent risk of alopecia areata in a prospective study of US women

Isabelle H Moseley et al. Arch Dermatol Res. 2023 May.

Abstract

Introduction: Alopecia areata (AA) is the most common form of immune-mediated hair loss. Studies have begun to establish the most frequent comorbid diseases of AA; however, results have been inconsistent with few prospective studies.

Methods: A total of 63,692 women in the Nurses' Health Study, 53-80 years, were prospectively followed from 2002 to 2014 to determine whether history of immune-mediated disease was associated with AA risk. Hazard ratios (HRs) and 95% confidence intervals (CIs) for AA in relation to immune-mediated conditions were computed using Cox proportional hazard models, adjusted for AA risk factors.

Results: 133 AA cases were identified during follow-up. Personal history of any immune-mediated disease was associated with increased AA risk (HR 1.72, 95% CI 1.24-2.37). History of systemic lupus erythematosus (HR 5.43, 95% CI 2.11-13.97), multiple sclerosis (HR 4.10, 95% CI 1.40-11.96), vitiligo (HR 3.13, 95% CI 1.08-9.10), psoriasis (HR 2.01, 95% CI 1.00-4.03), hypothyroidism (HR 1.88, 95% CI 1.30-2.71), and rheumatoid arthritis (HR 1.66, 95% CI 1.09-2.52) were associated with increased AA risk. History of inflammatory bowel disease or Graves' disease/hyperthyroidism was not significantly associated with AA risk.

Conclusions: In this prospective study, personal history of immune-mediated diseases either individually or overall was associated with increased AA risk.

Keywords: Alopecia areata; Autoimmune skin diseases; Comorbidities; Epidemiology; Immune-mediated diseases; Nurses’ Health Study.

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