Clinical Study for Alopecia Areata in Children under 12 Years old / 대한피부과학회지

ABSTRACT

BACKGROUND: Child hairs are not the same as adult hairs because human hair follicles produce different types of hairs throughout life from fetal stage to adult time through neonatal, childhood, and adolescent stage. Alopecia areata is a chronic recurrent hair disease caused by autoimmune mechanism. Considering above facts and psychophysical immaturity of children, there may be some difference in clinical and therapeutical aspects between childhood and adult in alopecia areata. OBJECTIVE: To observe and evaluate the characteristic clinical findings of alopecia areata in children. METHOD: 138 cases of alopecia areata developed before 12 years old were clinically studied and followed up for at least three years. RESULTS: 1. The total number of child patients(138) was 13.5% of total cases of alopecia areata(1,023) seen at the same period in the hospital. There was no sexual difference in this incidence. 2. The incidence rate was low before 5 years old. No case was found in neonatal stage. 97 cases(70%) developed after 6 years old. 3. 100 cases(72.5%) were common type showing one to several coin shaped bald lesions. 38 cases(27.5%) were severe type belonging to one of the following; alopecia universalis, alopecia totalis, alopecia semitotalis or ophiasis. 4. Intralesional injection of corticosteroid suspension was possible only after prior local anesthesia with anesthetic ointment(EMLA(R)) in 70%(41/59) even with buffering of the suspension and adding lidocain. 5. In common type, the overall therapeutic rate was 76.3%. In the cases of less than 6 months duration the rate was 90%, but no significant difference was found between the treated goup and the non-treated group with intralesional corticosteroid. In the cases of longer than 6 months the therapeutic rate was 20% but far better with intralesional injection group. 6. In severe type, the overall therapeutic rate was 44.1%(15/43). Intravenous pulse corticosteroid which was used for the type could be administered in safe in general. Follow-up observation up to 9 years revealed that 2(4.7%) patients who had taken the pulse therapy were under the 3 percentile of Koreans of that age in body height and weight.