Clinical patterns of alopecia areata in children in South Jordan

ABSTRACT

To describe the clinical patterns of alopecia areata in a group of children in Al-Karak City in the South of Jordan. This study was conducted at Prince Ali Ben Al-Hussein Hospital in Al-Karak City during the period June 2011 to May 2012. Patients who presented with alopecia areata and were aged less than 14 years old were included in the study. The diagnosis of alopecia areata was based on clinical grounds and was made by two expert dermatologists. All patients underwent a thorough history and physical examination. Age, gender, age of onset, type of alopecia, extent and duration of the disease, presence of specific signs, associated medical or dermatological conditions and nail involvement were recorded for all patients. Simple statistical analysis [frequencies, means and percentages] was used to describe the study variables. A total number of 58 pediatric patients were included in the study. There were 31 male and 27 female with a ratio of 1.11. The age of patients ranged from two to 14 years. The age of onset ranged from one to 13 years [mean = 7 years].The most common age of presentation was in the age group four to eight [34.5%] and eight to 12 [32.8%]. Most patients [77.6%] presented with limited alopecia areata, and 22.4% of patients presented with widespread alopecia areata. The majority of patients [77.6%] presented with primary alopecia areata and 22.4% of patients presented with recurrent alopecia areata. The mean duration of the disease was three months. Patients with primary alopecia areata had a median duration of two months while those with recurrent alopecia areata had a median duration of four months. Atopic dermatitis was found in 5 patients, vitiligo in one patient and thyroid disease in one patient. Severe alopecia areata was noted mainly in male patients [25.9%], younger age groups [66.7% of patients in the age group 0 to 4], patients with recurrent alopecia areata [60%], patients who had ophiasis [87.5%] and in all patients who had nail abnormality. Alopecia areata occurred in 5.9%, 0.6% and 0.2% of first, second and third degree relatives of patients respectively. There was a slight preponderance for male gender in pediatric alopecia areata in South Jordan. Most patients had limited alopecia areata. Severe alopecia areata is associated with male gender, younger age of onset, recurrent alopecia areata, presence of ophiasis and presence of nail involvement. Patients with recurrent disease tend to have a longer duration of their disease. Relatives of patients have a higher frequency of alopecia areata which indicates the important role of genetic factors