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Invited Commentary | Practice Gaps

Alopecia Areata and Comorbid Conditions Should We Screen Patients?  Comment on “Autoimmune, Atopic, and Mental Health Comorbid Conditions Associated With Alopecia Areata in the United States”

Antonella Tosti, MD1
[+] Author Affiliations
1Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida
JAMA Dermatol. 2013;149(7):794. doi:10.1001/jamadermatol.2013.360.
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Comorbidity is an emerging issue in dermatology, with increasing evidence that common dermatological diseases, such as psoriasis, can be associated with systemic conditions that severely affect patients’ health and even their life expectancy.

The study reported by Huang and coworkers1 in this issue shows that alopecia areata (AA) is commonly associated with autoimmune diseases, atopic dermatitis, and psychiatric problems. This is not new information; most of these associations have been well known for more than 50 years. In 1963, Muller and Winkelmann2 published in this journal a retrospective study of 736 patients with AA seen at the Mayo Clinic from 1945 to 1954. Comparing the results of the 2 studies, we see the same comorbid conditions reported, even if the prevalence is considerably higher in the current study for most conditions, as follows: atopy, 11% for Muller and Winkelmann2 vs 38.2% for Huang et al1; psychiatric disorders, 18% vs 25.5%; thyroid diseases, 8% vs 14.6%; diabetes mellitus, 2% vs 11.1%; vitiligo, 4% vs 2.8%; collagen diseases, 2% vs 8.2%; and ulcerative colitis, less than 1% vs 6.3% for inflammatory bowel disorders.

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