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Racial characteristics of alopecia areata in the United States - 08/09/20

Doi : 10.1016/j.jaad.2019.06.1300 
Hemin Lee, MD, MPH a, Sun Jae Jung, MD, PhD b, c, Anisha B. Patel, MD d, e, Jordan M. Thompson, MD f, Abrar Qureshi, MD, MPH f, g, h, Eunyoung Cho, ScD f, g, h,
a Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 
b Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea 
c Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 
d Dermatology Department, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas 
e Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 
f Department of Dermatology, The Warren Alpert Medical School, Brown University, Providence, Rhode Island 
g Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 
h Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island 

Reprint requests: Eunyoung Cho, ScD, Box G-D, Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI 02912.Box G-D, Department of DermatologyWarren Alpert Medical SchoolBrown UniversityProvidenceRI02912



Epidemiologic studies on the association between race and alopecia areata (AA) are limited.


To characterize racial differences of AA in the United States.


Cross-sectional study of self-registered AA patients and noncases in the National Alopecia Areata Registry (NAAR). We evaluated odds of AA and its subtypes for 5 ethnic/racial groups using logistic regression. A sex-stratified analysis and a sensitivity analysis among dermatologist-confirmed cases were also performed.


We identified 9340 AA patients and 2064 noncases. Compared with whites, African Americans had greater odds of AA (odds ratio, 1.77; 95% confidence interval, 1.37-2.28) and Asians had lower odds (odds ratio, 0.40; 95% confidence interval, 0.32-0.50) of AA. The results were consistent in AA subtypes, dermatologist-confirmed cases, and by sex.


Residual confounding due to limited number of covariates. Recall or recruitment bias not representative of the entire disease spectrum. Also, outcome misclassification was possible because not all AA cases in the registry were confirmed by dermatologists.


Our findings suggest higher odds of AA in African Americans and lower odds in Asians compared with whites. Future studies examining racial disparity in AA from clinical and genetic perspectives are warranted for a better understanding of the disease pathogenesis.

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Key words : alopecia areata, epidemiology, hair disorders, National Alopecia Areata Registry

Abbreviations used : AA, AAP, AAT, AT, AU, CI, NAAF, NAAR, NHS, NHSII, OR


 Funding sources: None.
 Conflicts of interest: Dr Qureshi has received honoraria that have been donated to charity from AbbVie, Amgen, Centers for Disease Control and Prevention, Janssen, Merck, Novartis, Pfizer (consultant), and Amgen (investigator). Dr Qureshi is an investigator for Sanofi/Regeneron with no financial compensation. Drs Lee, Jung, Patel, Thompson, and Cho have no conflicts of interest to report.

© 2019  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 83 - N° 4

P. 1064-1070 - octobre 2020 Retour au numéro
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