Patel D, et al. - Characterization was pursued of the thyroid function in children with alopecia areata (AA) in order to establish guidelines for screening. The intent was to reduce health care costs, eliminate unnecessary testing and standardize clinical practices. Routine thyroid function screening ought to be restricted to AA patients with a medical history of Down syndrome, personal history of atopy, a family history of thyroid disease, or clinical findings (goiter) indicative of potential thyroid dysfunction in the individual patient.

Methods

• The scheme of this research was a single-site retrospective medical chart review.
• It was conducted in an outpatient pediatric dermatology clinic in a tertiary referral medical center between January 1, 2008 and January 1, 2016.
• 298 patients (ages 0-21 years) who received a clinical diagnosis of AA and underwent thyroid function tests were enrolled for this study.
• The main outcome included the documentation of age at diagnosis of AA, duration of disease, severity, location, and type.
• Past medical history and family medical history of patients were then recorded.
• Results of laboratory tests including thyrotropin (formerly thyroid-stimulating hormone [TSH]), free T4 (FT4), triiodothyronine (T3), thyroid peroxidase antibodies (TPO-Abs), and thyroglobulin antibodies (Tg-Abs) were also encompassed.

Results

• 298 patients with AA underwent thyroid function screening, during the 8-year period.
• The patterns of AA were patchy (68%), ophiasis (13%), totalis (9%), and universalis (10%), among those with thyroid screening.
• An estimation was done of the severity in terms of percentage of hair loss on the scalp.
• The severity was divided into mild (30.2%), moderate (32.9%), and severe (36.9%).
• 59 (20%) patients reported abnormalities on thyroid testing results.
• Hypothyroidism was the most frequent finding 29 (49%), with Hashimoto thyroiditis being the most common cause(24 [41%]), in such patients.
• Other abnormalities constituted hyperthyroidism secondary to Grave disease (12 [20%]) and subclinical thyroid dysfunction (7 [12%]).
• Age, duration of disease, pattern of alopecia, and diagnosis of autoimmune diseases did not exhibit any prominent tie-up with abnormal thyroid findings, a personal history of Down syndrome (P = .004), atopy (P = .009), and family history of thyroid disease (P = .001) did.