Data is scarce with respect to childhood alopecia areata (AA).

A new study published in the Indian Dermatology Online Journal evaluated the clinico-epidemiological profile of childhood AA, with dermoscopic correlation.

This was a cross-sectional observational study that included 50 new cases of childhood AA, over a one-year period. Dermoscopy findings were recorded for each child.

The results revealed that childhood AA was more common in girls (M:F = 1:1.4); the mean age being 11.1 ± 3.7 years. Scalp was the commonest site of involvement in 86% cases, while 64% of the children had mild disease (<25% involvement). Localized circumscribed patch was the commonest presentation in74% children, whereas sisaipho was the least – in 2%. A positive family history of AA was noted in10% of the children. In addition, 48% children provided a history of atopic disorders and 30% had a positive family history of atopy. Stress was the commonest precipitating factor in 26% subjects. Nail involvement was observed in 38% children (pitting>thinning) while systemic associations like vitiligo and thyroid dysfunction were present in 26% and 24% cases, respectively. Furthermore, dermoscopy revealed yellow-dots to be the commonest finding in 88% cases, followed by short vellus hair and black dots in 76% and 28% children, respectively. Meanwhile, exclamation-mark hair was rare.

It was concluded that female gender, younger age, nail involvementand the presence of concomitant atopy, vitiligoand thyroid dysfunction were associated with severe disease, but not statistically significant. Dermoscopy is an important non-invasive tool for evaluating childhood AA. Moreover, ophiasis pattern and nail involvement must be actively pursued,owing to their association with severe disease.

Source: Indian Dermatology Online Journal. 2021 Mar-Apr; 12(2): 250–257.doi:10.4103/idoj.IDOJ_451_20