Background: Non-scarring alopecia is a common hair disorder with paucity of clinical review of this condition.
Objective: To review clinical characteristics and treatment rendered to non-scarring alopecia outpatients in a tertiary hospital in Malaysia.
Methods: A retrospective review was performed on non-scarring alopecia outpatients in University Malaya Medical Centre from January 2000 till December 2009. Medical records were reviewed on demographics, clinical characteristics and treatments.
Results: A total of 156 medical records were reviewed. Mean age at presentation was 24.5 ± 11.8 years with 30.1% of them below 18 years-old. Male to female ratio was 1:1.05. There were equal proportion of Malay and Indians (32.7%), followed by Chinese (26.9%) and others (7.7%). Alopecia areata accounted for 28.7% of the cases. The other diagnoses were androgenetic alopecia (12.1%), telogen effluvium (3.2%), trichotillomania (1.3%), tinea capitis (2.5%) and unspecified hair loss (52.2%).
The frequency of co-morbidities was anemia (5.8%), thyroid disorders (2.5%), atopy (1.9%) and diabetes mellitus (1.9%). Stress was identified in 5.8% of patients and 5.1% had family history of alopecia. Antinuclear factor was tested in 26 patients with 46.2% being positive. The proportion of patients who received prior treatment was 14.8%. Among patients with alopecia areata, majority received topical steroid (53.3%).Other treatment modalities were intralesional steroid (26.7%), topical minoxidil (17.8%), oral steroid (11.1%), oral finasteride (2.2%) and azathiopine used concurrently with oral steroid (2.2%). For androgenetic alopecia, majority were prescribed topical minoxidil (68.1%) and oral finasteride (10.5%). The percentage of patients lost to follow-up after first consultation was 39.7%.
Conclusion: Alopecia areata is the commonest cause of non-scarring alopecia. Pediatric patients made up a significant proportion of those with non-scarring alopecia. A high number of patients diagnosed with unspecified hair loss could reflect the lack of confidence among out-patient physicians in determining the cause of alopecia.