The prevalence of pediatric alopecia areata (AA) more than doubled from 2009 to 2020, according to study data published in JAMA Dermatology.
The finding is based on analysis of electronic health record (EHR) data from the PEDSnet database (version 4.0) from January 2009 to November 2020. Eligible participants were patients aged 18 years or younger with at least 2 physician visits in any clinical setting during for which a diagnosis code for AA was recorded or 1 dermatologist specialty visit for which AA was recorded.
A total of 5801 children (mean [SD] age, 9.0 [4.5] years; 56.2% female; 40.7% White) were included in the AA cohort. Of this group, 41.3% had 12 months or more of follow-up and were included in the incidence analysis.
The overall prevalence of pediatric AA was 0.11%. The prevalence increased steadily by year (0.04% in 2009 to 0.08% in 2019), with an overall 2-fold increase occurring from 2009 to 2019 and then decreasing slightly in 2020 (0.06%).
The overall incidence rate of pediatric AA from 2009 to 2020 was 13.6 patients per 100,000 person-years. The incidence rate according to age was normally distributed and peaked at age 6 years (0.09%). The rates were 22.8% higher in female participants compared with male participants, and they were highest in Hispanic children, followed by Asian children, Black children, and White children.
Logistic regression analysis was used to calculate adjusted odds ratios (aORs) and demonstrated general agreement with the unadjusted incidence data. Male patients were significantly less likely to receive a diagnosis of AA compared with female patients (aOR, 0.80; 95% CI, 0.74-0.87; P < .001). Hispanic children had the highest risk (aOR, 3.07; 95% CI, 2.76-3.42), followed by Asian children (aOR, 2.02; 95% CI, 1.67-2.44) and Black children (aOR, 1.73; 95% CI, 1.55-1.92), compared with White children.
Study limitations are associated with the use of EHR data, noted the researchers. Also, PEDSnet member institutions were all large and urban pediatric academic centers, which may have led to an overrepresentation of children with other medical disorders or complex disease.
“With these new data, efforts should be placed on increasing education in diverse communities to expand awareness about AA and access to care for children living with this disease,” the researchers concluded.
McKenzie PL, Maltenfort M, Bruckner AL, et al. Evaluation of the prevalence and incidence of pediatric alopecia areata using electronic health record data. JAMA Dermatol. Published online April 6, 2022. doi:10.1001/jamadermatol.2022.0351