A CASE-CONTROL STUDY TO ASSESS THE ASSOCIATION OF ALOPECIA AREATA WITH THYROID DYSFUNCTION AND THYROID AUTOIMMUNITY

Authors

  • Aamir Habib Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan
  • Mohsin Mehmood Ansari Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan
  • Arslan Ahmed Basra Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan
  • Hafsa Nazeer Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan
  • Asfa Ahmed Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan
  • Sohail Shaheen Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan

DOI:

https://doi.org/10.55519/JAMC-04-12361

Keywords:

Alopecia areata, clinical thyroid disease, subclinical thyroid disease, deranged thyroid function tests, thyroid autoimmunity, Anti-TPO antibodies

Abstract

Background: Several previous studies have suggested a positive association between Alopecia Areata and thyroid disorders. However, there is a paucity of such studies in our country. Our study aimed to know the frequency of thyroid dysfunction and thyroid autoimmunity in patients reporting to Dermatology Outdoors with Alopecia Areata (AA) and to compare it with normal controls. Methods: This was a Case-Control study conducted at the Dermatology outpatient of a tertiary care hospital in Pakistan.  102 patients with AA and 102 age and sex-matched controls were enrolled. The age of onset of the disease, the involved sites and the presence of other associated diseases were noted. Venous blood samples were taken from patients and controls for Thyroid function tests and Anti- Thyroid peroxidase antibodies (Anti-TPO Ab). The data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. Results: The mean age of onset of the disease was 30.37±12.53. 91.2% of patients had the classic patch type of AA. The most commonly involved site was Scalp. Associated diseases were found in eight (7.8%) patients. Thyroid dysfunction was found in two patients and none of the Controls.  Both the patients had Subclinical thyroid disease. The p-value was 0.157, which was not statistically significant. Thyroid autoimmunity (raised Anti-TPO Ab titre) was detected in five (4.90%) patients and none of the Controls. The p-value was 0.024, which was statistically significant. Conclusion: AA is significantly associated with Thyroid autoimmunity but there is no significant association between AA and clinical or subclinical thyroid disease.

Author Biographies

Aamir Habib, Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan

 

Mohsin Mehmood Ansari, Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan

 

Arslan Ahmed Basra, Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan

 

Hafsa Nazeer, Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan

 

Asfa Ahmed, Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan

 

Sohail Shaheen, Department of Dermatology, Combined Military Hospital, Bahawalpur-Pakistan

 

References

Strazzulla LC, Wang EHC, Avila L, Lo Sicco K, Brinster N, Christiano AM, et al. Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis. J Am Acad Dermatol 2018;78(1):1–12.

Zhou C, Li X, Wang C, Zhang J. Alopecia Areata: An Update on Etiopathogenesis, Diagnosis, and Management. Clin Rev Allergy Immunol 2021;61(3):403–23.

Sibbald C. Alopecia Areata: An Updated Review for 2023. J Cutan Med Surg 2023;27(3):241–59.

Juárez-Rendón KJ, Rivera Sánchez G, Reyes-López MÁ, García-Ortiz JE, Bocanegra-García V, Guardiola-Avila I, et al. Alopecia Areata. Current situation and perspectives. Arch Argent Pediatr 2017;115(6):e404–11.

Lee S, Lee H, Lee CH, Lee WS. Comorbidities in alopecia areata: A systematic review and meta-analysis. J Am Acad Dermatol 2019;80(2):466–77.e16.

Vrijman C, Kroon MW, Limpens J, Leeflang MM, Luiten RM, van der Veen JP, et al. The prevalence of thyroid disease in patients with vitiligo: a systematic review. Br J Dermatol 2012;167(6):1224–35.

Popa A, Carsote M, Cretoiu D, Dumitrascu MC, Nistor CE, Sandru F. Study of the Thyroid Profile of Patients with Alopecia. J Clin Med 2023;12(3):1115.

Asgher R, Luqman N, Almas U, Akhlaq A, Khalid M, Shaheen JA. Alopecia aeata: Clinical spectrum and its association with thyroid dysfunction in Bahawalpur. J Pak Assoc Dermatol 2020;30(1):9–12.

Puavilai S, Puavilai G, Charuwichitratana S, Sakuntabhai A, Sriprachya-Anunt S. Prevalence of thyroid diseases in patients with alopecia areata. Int J Dermatol 1994;33(9):632–3.

Marahatta S, Agrawal S, Mehata KD. Alopecia Areata and Thyroid Dysfunction Association- A Study from Eastern Nepal. Kathmandu Univ Med J 2018;62(2):161–5.

Shahzadi N, Pal SS, Asad F, Rani Z, Khurshid K. Frequency of autoimmune disorders in patients of alopecia areata. J Pak Assoc Dermatol 2016;26(2):112–7.

Fukuyama M, Ito T, Ohyama M. Alopecia areata: Current understanding of the pathophysiology and update on therapeutic approaches, featuring the Japanese Dermatological Association guidelines. J Dermatol 2022;49(1):19–36.

Kinoshita-Ise M, Martinez-Cabriales SA, Alhusayen R. Chronological association between alopecia areata and autoimmune thyroid diseases: A systematic review and meta-analysis. J Dermatol 2019;46(8):702–9.

Xin C, Sun X, Lu L, Yang R, Shan L, Wang Y. Increased Incidence of Thyroid Disease in Patients with Alopecia Areata: A Systematic Review and Meta-Analysis. Dermatology 2020;236(3):251–4

Díaz-Angulo S, López-Hoyos M, Muñoz-Cacho P, López-Escobar M, González-López MA. High prevalence of thyroid autoimmunity in patients with alopecia areata and vitiligo: a controlled study. Australas J Dermatol 2015;56(2):142–3.

Ejaz A, Jameel K, Suhail M. Pattern and profile of alopecia areata in Pakistan. J Pak Assoc Dermatol 2009;19:136–40.

Rahnama Z, Farajzadeh S, Mohamamdi S, Masoudi MA. Prevalence of thyroid disorders in patients with alopecia areata. J Pak Assoc Dermatol 2014;24(3):246–50.

Lyakhovitsky A, Shemer A, Amichai B. Increased prevalence of thyroid disorders in patients with new onset alopecia areata. Australas J Dermatol 2015;56(2):103–6.

Chu SY, Chen YJ, Tseng WC, Lin MW, Chen TJ, Hwang CY, et al. Comorbidity profiles among patients with alopecia areata: the importance of onset age, a nationwide population-based study. J Am Acad Dermatol 2011;65(5):949–56.

akry OA, Basha MA, El Shafiee MK, Shehata WA. Thyroid disorders associated with alopecia areata in Egyptian patients. Indian J Dermatol 2014;59(1):49–55.

Dai YX, Tai YH, Chang YT, Chen TJ, Chen MH. Bidirectional association between alopecia areata and thyroid diseases: a nationwide population-based cohort study. Arch Dermatol Res 2021;313(5):339–46.

Ahmed I, Nasreen S, Jehangir U, Wahid Z. Clinical spectrum of alopecia areata and its association with thyroid dysfunction. J Pak Assoc Dermatol 2012;22(3):207–12.

Park SM, Oh YJ, Lew BL, Sim WY. The association among thyroid dysfunction, thyroid autoimmunity, and clinical features of alopecia areata: A retrospective study. J Am Acad Dermatol 2019;81(2):602–5.

Baars MP, Greebe RJ, Pop VJ. High prevalence of thyroid peroxidase antibodies in patients with alopecia areata. J Eur Acad Dermatol Venereol 2013;27(1):e137–9.

Kasumagić-Halilović E. Thyroid autoimmunity in patients with alopecia areata. Acta Dermatovenerol Croat 2008;16(3):123–5.

Additional Files

Published

2023-12-22