Alopecia Areata Significantly Associated With Various Inflammatory Arthropathies

Alopecia areata has a significant association with rheumatoid arthritis, inflammatory spondyloarthropathies, spondylosis, and other unspecified arthropathy/arthritis, according to study findings presented at the 2023 Annual Meeting of the American Academy of Dermatology (AAD), held from March 17 to 21, 2023, in New Orleans, Louisiana.

Investigators conducted a case-controlled retrospective cohort study using the electronic medical records database from the University of California, Irvine to determine whether alopecia areata is associated with inflammatory arthritic conditions in addition to rheumatoid arthritis.

A total of 422 patients with alopecia areata and also diagnosed with inflammatory arthropathies were matched to a control cohort with 16,657 dermatology patients without a history of inflammatory skin conditions. Patients in the alopecia areata group and control group were comparable in sex and race, though there was variance in average age (41 vs 48 years, respectively).

Investigators confirmed the association between alopecia areata and rheumatoid arthritis (odds ratio [OR], 3.94; 95% CI, 2.04-7.60; P <.0001) and noted significant associations with inflammatory spondyloarthropathies (OR, 1.89; 95% CI, 1.19-2.99; P =.0065), unspecified arthropathy/arthritis (OR, 2.63; 95% CI, 1.22-5.69; P =.0138), and spondylosis (OR, 1.62; 95% CI, 1.08-2.45). Patients in the control cohort did not have an association with other inflammatory arthritic conditions.

Investigators found no significant association between alopecia areata and gout (OR, 0.74; 95% CI, 0.18-2.99; P =.6691), juvenile arthritis (OR, 1.71; 95% CI, 0.10-29.12; P =.7096), enteropathic arthropathies (OR, 13.14; 95% CI, 0.53-323.07), ankylosing spondylitis (OR, 3.60; 95% CI, 0.84-15.36), psoriatic arthritis (OR, 1.26; 95% CI, 0.40-4.00), or other crystal arthropathies (OR, 1.61; 95% CI, 0.39-6.65).

“Our study found a significant association between certain inflammatory arthropathies in patients with [alopecia areata],” the investigators concluded, noting that the association may be attributed to shared inflammatory mediators/pathways such as interleukin-17 and Janus kinase/signal transducers and activators of transcription. “Patients with [alopecia areata] may benefit from screening for arthropathies to facilitate appropriate management.”