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Epidemiology of alopecia areata, ophiasis, totalis, and universalis: A systematic review and meta-analysis
Abstract
BACKGROUND Alopecia areata (AA) is a common, autoimmune, alopecia with heterogeneous severity and distribution. Previous studies found conflicting results about AA epidemiology. OBJECTIVE Determine the prevalence, incidence and predictors of AA, alopecia totalis (AT), ophiasis (AO), and universalis (AU). METHODS A systematic review of all published cohort and cross-sectional studies that analyzed AA and its subtypes. MEDLINE, EMBASE, LILACS, Scopus, Cochrane library and GREAT were searched. At least 2 reviewers performed study title/abstract review and data extraction. Random-effects meta-analysis was used owing to significant heterogeneity (I2=99.97%). RESULTS Ninety-four studies met inclusion criteria. The pooled prevalence (95% confidence interval [CI], n) of AA overall was 2.11% (1.82-2.42%, n=302,157,365), with differences of population-based (0.75% [0.49-1.06%], n=301,173,403) and clinic-based (3.47% [3.01-3.96%], n=983962) studies. The prevalences of alopecia totalis, ophiasis, and universalis were 0.08% (0.04-0.13%, n=1,088,149), 0.02% (0.00-0.06%, n=1,075,203), and 0.03% (0.01-0.06%, n=1,085,444), respectively. AA prevalence [95% CI] increased over time (<2000: 1.02% [0.85-1.22%]; 2000-2009: 1.76% [1.51-2.03%]); >2009: 3.22% [2.59-3.92%]; P<0.0001) and differed by region. AA prevalence was significantly lower in adults (1.47% [1.18-1.80%]) than children (1.92% [1.31-2.65%]; P<0.0001). CONCLUSIONS AA affects 2% of the global population. AA prevalence is lower in adults than children, is increasing over time, and significantly differs by region.
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Bechelli, L. M., Haddad, N., Pimenta, W. P., Pagnano, P. M. G., Melchior, Jr., Fregnan, R. C., Zanin, L. C., & Arenas, A. (2009) · Dermatologica · doi:10.1159/000250144 · Cited by 111
The spectrum of dermatological disorders among primary school children in Dar es Salaam
Komba, E. V., & Mgonda, Y. M. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-765 · Cited by 86
Cited by
King, B., Zhang, X., Harcha, W. G., Szepietowski, J. C., Shapiro, J., Lynde, C., Mesinkovska, N. A., Zwillich, S. H., Napatalung, L., Wajsbrot, D., et al. (2023) · The Lancet · doi:10.1016/s0140-6736(23)00222-2 · Cited by 298
Unmet medical needs in chronic, non-communicable inflammatory skin diseases
Ujiie, H., Rosmarin, D., Schön, M. P., Ständer, S., Boch, K., Metz, M., Maurer, M., Thaci, D., Schmidt, E., Cole, C., et al. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.875492 · Cited by 158
Hu, B. D., He, H., Bose, S., Gour, D., Nandymazumdar, M., Zhou, J., Golla, A., del Duca, E., Beaziz, J., Avallone, G., et al. (2026) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2026.02.014 · Cited by 5
Metadata
- Authors
- Lee, H. H., Gwillim, E., Patel, K. R., Hua, T., Rastogi, S., Ibler, E., & Silverberg, J. I.
- Venue
- Journal of the American Academy of Dermatology
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 82
- Issue
- 3
- Pages
- 675-682
- ISSN
- 0190-9622 (ISSN-L)
- OpenAlex
- W2969631385
- Cited by
- 345
- References
- 2
- FWCI
- 5.86
- Type
- journal article
- Language
- en
- Open access
- closed
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- Lee, H. H., Gwillim, E., Patel, K. R., Hua, T., Rastogi, S., Ibler, E., & Silverberg, J. I. (2020). Epidemiology of alopecia areata, ophiasis, totalis, and universalis: A systematic review and meta-analysis. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2019.08.032
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