Patel D, et al. - This trial entailed the characterization of thyroid function in children with alopecia areata (AA) for establishing guidelines for screening. The intent was to reduce health care costs, annihilate unnecessary investigation, and standardize clinical practices. Restriction of routine thyroid function screening was recommended in 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 design of this study was a single-site retrospective medical chart review.
• It was performed in an outpatient pediatric dermatology clinic in a tertiary referral medical center between January 1, 2008 and January 1, 2016.
• Herein, 298 patients (ages 0-21 years) who received a clinical diagnosis of AA and underwent thyroid function tests, were eligible for this study.
• The main outcome measure included the documentation of age at diagnosis of AA, duration of disease, severity, location, and type.
• In addition, the past medical history and family medical history of patients were recorded.
• Results of laboratory tests, for instance, thyrotropin (formerly thyroid-stimulating hormone [TSH]), free T4 (FT4), triiodothyronine (T3), thyroid peroxidase antibodies (TPO-Abs), and thyroglobulin antibodies (Tg-Abs) were also included.

Results

• During this trial, 298 patients with AA underwent thyroid function screening, in the 8-year period.
• Among those with thyroid screening, patterns of AA consisted of patchy (68%), ophiasis (13%), totalis (9%), and universalis (10%).
• Severity was gauged via the percentage of hair loss on the scalp and were divided into mild (30.2%), moderate (32.9%), and severe (36.9%). 59 (20%) patients reported abnormalities on thyroid testing results.
• Hypothyroidism was determined as the most frequent finding 29 (49%), with Hashimoto thyroiditis being the most common cause(24 [41%]), in this cohort.
• Other abnormalities consisted of hyperthyroidism secondary to Grave disease (12 [20%]) and subclinical thyroid dysfunction (7 [12%]).
• In contrast, age, duration of disease, pattern of alopecia, and diagnosis of autoimmune diseases did not illustrate any marked correlation with abnormal thyroid findings, a personal history of Down syndrome (P=.004), atopy (P=.009), and family history of thyroid disease (P=. 001) did.