Objective: We studied the demography, clinical patterns, management strategies and outcome of alopecia areata of a multi ethnic population in a tertiary dermatology centre.
Methodology: We retrospectively reviewed 200 case notes extracted randomly from the computer records of 497 patients diagnosed with alopecia areata in the Department of Dermatology, Kuala Lumpur Hospital from January 1987 until June 2009.
Result: The median age of presentation was 25 years old. Male to female ratio was 1.38:1. Patients of Indian origin had a higher prevalence (35.5%). The median duration of disease was 3 months before presentation. Twelve patients (6%) had personal history of atopy. Six patients (3%) had autoimmune diseases with 4 had thyroid disease, 1 ulcerative colitis and 1 vitiligo. Seven patients (3.5%) had positive family history. The majority of patients (197, 98.5%) had scalp involvement with or without alopecia over eyebrow, eyelash, beard or moustache area. Of these patients, 3 had ophiasis. One patient (0.05%) had alopecia totalis and 2 patients (1%) had alopecia universalis. The treatment included topical corticosteroids, intralesional triamcinolone acetonide, treatment with 0.5% dithranol, 0.1% tacrolimus ointment, 2-5% minoxidil lotion, 2% salicylic acid ointment, 0.5% acetic acid ointment, topical PUVA and short courses of prednisolone. About 41% (82) of patients defaulted after the first clinic visit. Among the remaining 118 patients, complete resolution was noted in 18.6%; 27.1% experienced partial hair regrowth of more than 50%, 38.1% had partial hair regrowth of less than 50%, 8.5% did not have any hair regrowth and 7.6% experienced recurrence of disease during the period of follow up.
Conclusion: The majority of our patients had scalp alopecia areata. All received topical steroids with or without other topical treatment. Overall outcome was mediocre with complete response in less than 20% of patients.