Alopecia areata totalis and universalis: a multicenter review of 132 patients in Spain.
BACKGROUND
Alopecia areata totalis (AAT) and universalis (AAU) pose a therapeutic challenge.


OBJECTIVE
To describe the clinical and epidemiological features, therapeutic response and prognostic factors in a large series of patients diagnosed with AAT and AAU.


METHODS
This retrospective multicenter study included patients diagnosed with AAT/AAU with a minimum follow-up of 12 months. Response was assessed based on the regrowth of scalp hair.


RESULTS
In all, 132 patients (92 women and 40 men) - 80 (61%) diagnosed with AAU and 52 (39%) diagnosed with AAT - were included. The median time between the presentation of alopecia areata (AA) and the development of extensive AA was 1 year and it was less than 4 years in 121 patients (91%). There was an initial response to treatment in 64% of patients, although only 14% presented a persistent response. Adverse side effects from the medications used were detected in 33% of patients. The prognostic factors associated with poor response were the presence of AAU and a positive family history of AA.


CONCLUSIONS
Treatment of AAT and AAU is challenging. Although an initial regrowth may be achieved, the duration of response is usually short. There were no significant differences on the effectiveness or duration of response between the various systemic therapies.
Dermatology Service, Trichology Unit, Ramon y Cajal Hospital, IRYCIS, University of Alcala, Madrid, Spain.
S
S
Vañó-Galván
Dermatology Service, Hospital Universitario Reina Sofía, Instituto Maimónides de Investigación Biomédica (IMIBIC), Córdoba, Spain.
P
P
Fernández-Crehuet
Universitat Internacional de Catalunya, Barcelona, Spain.
R
R
Grimalt
Virgen Macarena, Sevilla, Spain.
M J
MJ
Garcia-Hernandez
Grupo Pedro Jaén, Madrid, Spain.
R
R
Rodrigues-Barata
Unidad de Gestión Clínica de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen de las Nieves, Granada, Spain.
S
S
Arias-Santiago
Fundación Jiménez-Diaz, Madrid, Spain.
A
A
Molina-Ruiz
Dermatology Department, Hospital Virgen de las Nieves-Granada, Madrid, Spain.
E
E
Garcia-Lora
Virgen del Roc!ıo, Sevilla, Spain.
J
J
Dominguez-Cruz
Clinic-Barcelona, Barcelona, Spain.
A
A
Brugues
Clinic-Barcelona, Barcelona, Spain.
J
J
Ferrando
Dermatology Service, Hospital de Guadix de Granada, Granada, Spain.
C
C
Serrano-Falcón
Dermatology Department, Universidad de Granada, Granada, Spain.
S
S
Serrano
Department of Dermatology and Venereology, Sahlgrenska University Hospital, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
J
J
Paoli
Virgen Macarena, Sevilla, Spain.
F
F
Camacho
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000505:Alopecia / Q000175:diagnosis / Q000628:therapy*; D000506:Alopecia Areata / Q000175:diagnosis / Q000235:genetics / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult