Pediatric Alopecia Areata: Incidence rates have Doubled!

The Epidemiology of Alopecia Areata in US Children:

Authors set out to determine the prevalence and incidence of alopecia areata in a pediatric population across time, age, sex, race and ethnicity, and geographic areas within the US.

The study was a multicenter cohort study conducted among 5 children’s hospitals over a period January 2009 to November 2020. Data was extracted from a large electronic health records data base known as PEDSnet.

The data base included over 5 409 919 patients of which there were over 5800 children with alopecia areata. 2398 (41.3%) children had 12 months or more of follow-up and were included in the incidence analysis.

A new study suggests that the rates of pediatric alopecia areata have increased in the last decade.

Results

Of 5801 patients in the AA cohort, the mean age was 9.0 years. 56.2% of patients were female. 41 % were White, 19 % Black, 23 % Hispanic and 6 % Asian.

The authors calculated the overall prevalence of pediatric AA to be 0.11%. The prevalence by year increased steadily, with an overall 2-fold increase from 2009 to 2019. The prevalence was 0.04 % in 2009 and 0.08 % in 20019. The rate dipped a bit in 2020.

The 11-year overall incidence rate of pediatric AA between 2009 and 2020 was calculated to be 13.6 cases per 100 000 person-years (95% CI, 13.1-14.2). The incidence rate according to age group was normally distributed and peaked at age 6 years. Rates were 22.8% higher in female patients than male patients (15.1 cases per 100 000 person-years for females vs 12.3 cases per 100 000 person-years for males). Additionally, incidence rates were highest among Hispanic children (31.5 cases per 100 000 person-years). Asian children had an incidence rate of 21.3 cases per 100 000 person-years. Black children had an incidence rate of 17 cases per 100 000 person-years. White children had a rate of 8.8 cases per 100 000 person-years.

Conclusions

This is a really valuable study which outlines the current epidemiology of alopecia areata in the US. It highlights the increase incidence in Hispanic, black and Asian children compared to white children and moreover captures what appears to be a doubling of alopecia areata incidence over a 10 year period.

REFERENCE

McKenzie P et al. Evaluation of the Prevalence and Incidence of Pediatric Alopecia Areata Using Electronic Health Record Data. JAMA Dermatol. 2022 May 1;158(5):547-551.