Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug;36(4):236-246.
doi: 10.5021/ad.24.058.

Korean Consensus Criteria for the Severity Classification of Alopecia Areata

Yong Hyun Jang  1 , Seung Soo Lee  1 , Do Young Park  1 , Young Lee  2 , Do-Young Kim  3 , Hyunsun Park  4 , Hyun-Tae Shin  5 , Jung Eun Kim  6 , Kihyuk Shin  7 , Ji Hae Lee  8 , Jee Woong Choi  9 , Byung Choel Park  10 , Beom Joon Kim  11 , Soo Hong Seo  12 , Chong Hyun Won  13 , Jin Park  14 , Min Sung Kim  15 , Sang Seok Kim  16 , Bark-Lynn Lew  17 , Chang-Hun Huh  18 , Ohsang Kwon  19 , Yang Won Lee  20 , Moon-Bum Kim  21 ; Korean Hair Research Society
Affiliations

Korean Consensus Criteria for the Severity Classification of Alopecia Areata

Yong Hyun Jang et al. Ann Dermatol. 2024 Aug.

Abstract

Background: A set of criteria for severity classification is essential in alopecia areata (AA). Currently, no guidelines are universally accepted for defining AA severity.

Objective: This study aimed to establish a set of consensus criteria for classifying the severity of and identifying treatment refractoriness in AA.

Methods: A preliminary draft of the definition for moderate-to-severe AA was crafted based on available evidence, and members of the Korean Hair Research Society (KHRS) subsequently endorsed the recommendation through an online survey.

Results: In the first Delphi round, consensus was attained on 15 questions. After refining certain items in the second round, consensus was achieved on 23 out of 26 questions. The KHRS first defined AA severity using the severity of alopecia tool (SALT). SALT ≥50 was defined as severe, 20≤ SALT <50 as moderate, and SALT <20 as mild. Moderate AA was considered severe if it meets one or more of the following criteria: dermatology life quality index >10, presence of accompanying eyebrow or eyelash loss, positive hair loss activity, or treatment-refractory AA.

Conclusion: These consensus criteria can help clinicians accurately diagnose AA, provide appropriate treatment, and monitor its progression.

Keywords: Alopecia areata; Consensus; Criteria; Severity.

PubMed Disclaimer

Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Flowchart of the Delphi study building toward reporting the AA severity criteria.
AA: alopecia areata.
Fig. 2
Fig. 2. Korean consensus criteria for the severity classification of AA.
AA: alopecia areata, SALT: severity of alopecia tool, DLQI: dermatology life quality index. *In pediatric patients, the children’s dermatology life quality index is used. †Investigate “whether there is distinct eyebrow or eyelash loss” when assessing AA severity. ‡Investigated by “positive hair pull test or dermoscopic findings (black dots, tapering hair, and broken hairs).” §Treatment-refractory AA: failure to reach SALT score improvement of ≥30% or still has >20% scalp hair loss despite 24 weeks of appropriate treatment?
See this image and copyright information in PMC

References

    1. Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, et al. Alopecia areata: disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol. 2018;78:1–12. - PubMed
    1. Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, et al. Alopecia areata: an appraisal of new treatment approaches and overview of current therapies. J Am Acad Dermatol. 2018;78:15–24. - PubMed
    1. Park H, Kim JE, Choi JW, Kim DY, Jang YH, Lee Y, et al. Guidelines for the management of patients with alopecia areata in Korea: part I topical and device-based treatment. Ann Dermatol. 2023;35:190–204. - PMC - PubMed
    1. King BA, Senna MM, Ohyama M, Tosti A, Sinclair RD, Ball S, et al. Defining severity in alopecia areata: current perspectives and a multidimensional framework. Dermatol Ther (Heidelb) 2022;12:825–834. - PMC - PubMed
    1. Cranwell WC, Lai VW, Photiou L, Meah N, Wall D, Rathnayake D, et al. Treatment of alopecia areata: an Australian expert consensus statement. Australas J Dermatol. 2019;60:163–170. - PubMed

LinkOut - more resources