Features of sensitization in patients with alopecia areata, associated with atopic diseases

BACKGROUND: Association of alopecia areata and atopic diseases has been confirmed in clinical, epidemiologic, genetic and immunologic studies. The study of sensitization features and atopic diseases structure in alopecia areata patients makes it possible to phenotype patients with atopy and consider additional treatment options for alopecia areata. AIM: To determine the sensitization spectrum and atopic diseases structure in alopecia areata patients considering the age and clinical form of alopecia. MATERIALS AND METHODS: A comparative uncontrolled study was conducted. The data of 162 patients 5–51 years with alopecia areata, atopic dermatitis, asthma, allergic rhinitis/rhinoconjuctivitis for the period from April 2022 to May 2023 were used. The nature of sensitization and the structure of atopic diseases were analyzed. Clinical forms of alopecia areata were assessed by the hair-loss area. RESULTS: The patients were divided according to alopecia areata status: the first group included 54 alopecia areata patients with atopic diseases, the second ― 108 atopic patients without alopecia areata. Subgroups were formed according to age: in group 1 the mean age was 16.3±1.38 years, 57% were children (5–17 years), 43% were older 18 years; in group 2 the mean age was 17.1±1.43 years, 54% children and 46% adults. Among alopecia areata patients seasonal pollen sensitization prevailed (22/54 people); polyvalent sensitization was observed in 13/54 people, 6 of whom had severe forms of alopecia areata, 6 ― ophiasis. Comparison of the sensitization spectrum between the groups revealed no differences. In group of adult alopecia areata patients isolated respiratory allergies were significantly less frequent (OR 0.21; CI 0.07–0.60; p=0.004), but combined atopic diseases were more frequently observed (OR 4.71; CI 1.43–15.58; p=0.012). Most patients with severe alopecia areata were children (8/12) with polyvalent sensitization and respiratory and combined atopic diseases. CONCLUSION: The comorbidity of alopecia areata and atopy is manifested by an increased incidence of severe alopecia in childhood and a tendency to progression of allergic inflammation, realized as combined atopic diseases. The spectrum of sensitization in patients with and without alopecia areata does not differ and characterized by the predominance of the most common allergens (plant pollen). These results indicate the need for timely phenotyping of alopecia areata patients with allergic predisposition, especially with early onset and progressive alopecia.