Late Onset Alopecia Areata: What are the Features?

Late Onset Alopecia Areata (LOAA)

Alopecia areata is an autoimmune disease that affects about 2 % of the world. About 50 % of patients who develop alopecia areata will develop their first episode of hair loss before age 20. The development of the first episode of alopecia areata after the age of 50 is uncommon.  Alopecia areata first occurring after age 50 is frequently referred to as late onset alopecia areaeta (LOAA).

What are the characteristics of patients who develop LOAA? 

In 2017, Lyakhovitsky and colleagues set out to determine the features of patients who develop LOAA. They performed a retrospective cohort study of patients visiting a tertiary centre over the 6 year period (January 2009 and April 2015).

Of 29 patients in their study who were found to have LOAA, 86.2% were female (female-to-male ratio, 6.2:1). There was a family history of alopecia areata in 17.2%, thyroid disease in 31%, atopic background in 6.9%, and 17/29 (58.6%) reported a significant stressful event. The most common disease pattern observed as the so called 'patchy' subtype. Interestingly the disease was mild in the majority of participants. Complete hair regrowth was observed in 82.8% of participants, and 37.9% relapsed.

Conclusion and Comments

This is a nice study which examines the characteristics of patients who develop their very first patch of alopecia after age 50. This group of patients appears have have less extensive disease, and frequently has complete hair regrowth. Affected patients are more likely to be  female than male.   

REFERENCE

Lyakhovitsky A, et al. Dermatology. 2017.