A new study revealed that patients with comorbid bronchial asthma, atopic dermatitis, and Hashimoto's thyroiditis face significantly increased risks of developing early-onset, severe, and prolonged alopecia areata, a common autoimmune disease characterized by sudden, non-scarring hair loss.

Published in Allergy, the findings are based on data from 2657 mainly Central European alopecia areata (AA) patients recruited from outpatient clinics, dermatology practitioners, and self-support groups in Germany and Belgium.

The study found that 53.7% of participants reported at least 1 chronic inflammatory disorder (CID), with 44.5% having an atopic CID such as atopic dermatitis (26.7%), bronchial asthma (13.4%), or rhinitis (26.7%). Among non-atopic CIDs, Hashimoto's thyroiditis was most common (6.1%), followed by vitiligo (4.6%), psoriasis (2.7%), and rheumatoid arthritis (1.7%).

The study defined early-onset AA as hair loss before age 20, severe AA as total scalp hair loss (alopecia totalis) or complete body hair loss (alopecia universalis), and prolonged AA as episodes lasting more than 2 years.

Analysis showed patients with comorbid bronchial asthma had the highest risk increase for early-onset (odds ratio [OR], 1.606; 95% CI, 1.199-2.151), severe (OR, 1.444; 95% CI, 1.111-1.878), and prolonged AA (OR, 1.604; 95% CI, 1.200-2.143) compared to patients without comorbidities. Additionally, patients with all 3 atopic conditions (atopic dermatitis, bronchial asthma, and rhinitis) developed AA nearly 10 years earlier than those without comorbidities.

The study, supported by the Deutsche Forschungsgemeinschaft as part of the German Excellence Strategy (EXC2151-390873048), examined associations between AA clinical features and chronic inflammatory disorder comorbidity status in this patient population. 

The authors declared no conflicts of interest.