BH15 The burden of alopecia areata: examining baseline health-related quality of life and clinical assessment tools

• Published in: British journal of dermatology (1951) 2024-06, Vol.191 (Supplement_1), p.i79-i80
• Main Authors: Boyle, Aoife, Wall, Dmitri, McDonald, Ian
• Format: Article
• Language: English
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1093/bjd/ljae090.162

Alopecia areata (AA) is an autoimmune-mediated, nonscarring hair loss that affects 2% of the population. Patients with AA experience significant impairment in health-related quality of life (HRQoL), particularly mental health (Senna M, Ko J, Glashofer M et al. Predictors of QOL in patients with alopecia areata. J Invest Dermatol 2022; 142: 2646–50). The Severity of Alopecia Tool (SALT) is a physician-derived, semiobjective measure, frequently used in clinical practice, that calculates the extent of scalp hair loss. Nonscalp hair or quality of life is not incorporated and may explain why SALT can underestimate the overall impact of AA (Senna et al.; Wall D, Rees H, Bokhari L et al. Signposts to the promised land in alopecia areata. J Invest Dermatol 2023; 143: 9–10). The Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HADS) are common HRQoL assessments. Emerging disease-specific tools, which examine both hair loss extent and quality-of-life impact, include the Alopecia Areata Patient Priority Outcomes (AAPPO) and the Alopecia Areata Symptom Impact Scale (AASIS). This study aimed to determine the baseline HRQoL burden among adult patients with AA in a newly developed hair research clinic. A secondary aim was to examine how HRQoL assessments compared with SALT vs. newer compound measures, AAPPO and AASIS. A retrospective chart review identified 20 patients with complete data. The mean SALT score was 61.2. The mean DLQI score was 11.05, indicating a very large impact on QoL as measured by DLQI bands. Overall, 15% of patients experienced no effect, 25% a small effect, 10% a moderate effect, 30% a very large effect and 20% an extremely large effect. The mean HADS-D (depression) score was 8, indicating a borderline score. In total, 47% had normal scores, 21% had borderline scores and 32% had abnormal scores. Similarly, the mean HADS-A (anxiety) score was borderline at 9.9; 26% had normal scores, 21% borderline scores and 53% abnormal scores. The mean total AAPPO score was 16.8 out of 44. The highest mean subscore was the emotional symptoms subscore of 9.9 out of 16, followed by a hair loss subscore of 9 out of 16 and an activity limitations subscore of 3.9 out of 12. The mean total AASIS score was 118 out of 170. The highest mean subscore was the symptoms subscore of 36.9 out of 70, followed by the feelings subscore of 17.5 out of 40 and daily functioning subscore of 24.1 out of 60. SALT had a nonsignificant positive association w