A study examining the prevalence and incidence of pediatric alopecia areata (AA) from 2009 to 2020 has determined that prevalence has doubled during that decade to 0.11%, with an incidence rate of 13.6 cases per 100,000 person-years. The researchers noted that this information is key to understanding the natural history of this disease.
Published in JAMA Dermatology, the prevalence denominator population in this study included 5,409,919 patients. The incidence denominator population was 2,896,241. The authors noted that a total of 5,801 children were included in the AA cohort, and 2,398 (41.3%) had 12 months or more of follow-up and were included in the incidence analysis.
Data were collected from the PEDSnet database (version 4.0) and included patients younger than 18 years of age with at least two physician visits where a diagnostic code for AA was recorded, or one dermatologist visit where AA was recorded.
The investigators were particularly interested in age, sex, race and ethnicity, and geographic region of pediatric patients diagnosed with AA.
There were 5,801 patients in the AA cohort, with a mean age of nine years. The number of females was 3,259 (56.2%), 359 (6.2%) were Asian, 1,094 (18.9%) were Black, 1,348 (23.2%) were Hispanic, and 2,362 (40.7%) were White. The researchers noted that individuals in the AA cohort were more often older, female, and members of a racial and ethnic minority group than the full PEDSnet population. AA was also found to be most prevalent among children who identified as Hispanic (0.23%) and Asian (0.17%).
The incidence rate by age was normally distributed and peaked at age six years. The authors reported that rates were 22.8% higher in female patients than male patients (15.1 cases per 100,000 person-years for females vs. 12.3 cases per 100,000 person-years for males). They also found that incidence rates were highest among Hispanic children (31.5 cases per 100,000 person-years).
“One of the most remarkable findings in this study was the much higher AA incidence rates in patients who self-identified by race and ethnicity as Hispanic and Asian compared with those who identified as White,” the authors wrote.
“This information can potentially assist clinicians in advocating for resources for children with AA and payers and health systems in planning for AA therapeutics.”