COLLAB: A Global Survey of Clinical and Laboratory Assessment in Alopecia Areata by Hair Specialists

ABSTRACT Background Alopecia areata (AA) is a common non‐scarring alopecia. Data continue to emerge on associations with autoimmune and other conditions. Janus kinase inhibitors (JAKi) are increasingly used to treat AA. Objectives The aim was to assess variation in laboratory testing in patients with AA among hair experts internationally and to compare subspecialized clinical practice to current guidelines. Methods Thirty hair experts from 14 countries and six continents contributed to develop a 24‐item survey collecting demographic information on respondents; methods of severity assessment; and laboratory testing practices in AA for mimics, contributory factors, associations, and workup for systemic therapy. The survey was distributed to a global network of expert hair specialists. Results Of 214 respondents, 79.9% (171/214) had special interest/expertise in hair loss disorders, and 35.5% ( n = 76) were based in Europe. Most cared for both adults and children (87.9%, n = 188). For clinical assessment, almost two‐thirds (63.6%, n = 136) used the Severity of Alopecia Tool and 38% ( n = 84) used the Dermatology Life Quality Index. Only 24.3% ( n = 52) typically tested for alternative infectious or inflammatory diagnoses, 39.7% ( n = 85) typically tested for contributory conditions such as nutritional deficiencies, and 50.9% ( n = 109) typically tested for co‐existent autoimmune illnesses. Thyroid function testing was routinely performed in 73.4% ( n = 157) and complete blood count (CBC) was checked in 65.9% ( n = 141). Compared to conventional systemic therapy, experts were more likely to check lipid levels, creatine kinase, coagulation profiles, thrombophilia screens, tuberculosis blood testing, hepatitis B and C serology before prescribing JAKi. Conclusions Real world practice of laboratory testing for AA by hair experts, who may see more severe or complex alopecia, is variable. Most experts routinely perform thyroid function and CBC testing. We discuss evidence for indications for testing for AA mimics, contributory factors, associated autoimmune conditions, and before systemic therapy. Further research is required to characterise the role of laboratory testing in AA.

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Publication Details

Journal
JEADV Clinical Practice
Published
2025-05-23
DOI
https://doi.org/10.1002/jvc2.70067
Primary Topic
Hair Growth and Disorders
Type
article
Field-Weighted Citation Impact
0.00

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article

COLLAB: A Global Survey of Clinical and Laboratory Assessment in Alopecia Areata by Hair Specialists

Leila Asfour, Manabu Ohyama, Jerry Shapiro, Rodrigo Pirmez et al.
JEADV Clinical Practice
Hair Growth and Disorders
article

COLLAB: A Global Survey of Clinical and Laboratory Assessment in Alopecia Areata by Hair Specialists

Leila Asfour, Manabu Ohyama, Jerry Shapiro, Rodrigo Pirmez, Samantha Eisman, Ahmed Kazmi, Sergio Vañó‐Galván, Rachita Dhurat, Cathal O’Connor, Maria Kramarczuk Hordinsky, Dmitri Wall, David Saceda‐Corralo, Bianca Maria Piraccini, Isabella Doche, Nekma Meah, Brittany G. Craiglow, Bevin Bhoyrul, Aaron M. Drucker, Rodney Sinclair, Antonios G.A. Kolios, Yuliya Ovcharenko, Laita Bokhari, George Cotsarelis, Katherine York, Aoife Boyle, Ncoza Cordelia Dlova, Lidia Rudnicka, Paradi Mirmirani, Blake R. C. Smith, Lara Cutlar, Brett King, Matthew Harries, Daniel Fernandes Melo, C. Cotter, Arash Mostaghimi, Michela Valeria Rita Starace, Ian McDonald, Cathryn Sibbald, Wooseok Koh, Jeffrey C. H. Donovan
article en

Abstract

ABSTRACT Background Alopecia areata (AA) is a common non‐scarring alopecia. Data continue to emerge on associations with autoimmune and other conditions. Janus kinase inhibitors (JAKi) are increasingly used to treat AA. Objectives The aim was to assess variation in laboratory testing in patients with AA among hair experts internationally and to compare subspecialized clinical practice to current guidelines. Methods Thirty hair experts from 14 countries and six continents contributed to develop a 24‐item survey collecting demographic information on respondents; methods of severity assessment; and laboratory testing practices in AA for mimics, contributory factors, associations, and workup for systemic therapy. The survey was distributed to a global network of expert hair specialists. Results Of 214 respondents, 79.9% (171/214) had special interest/expertise in hair loss disorders, and 35.5% ( n = 76) were based in Europe. Most cared for both adults and children (87.9%, n = 188). For clinical assessment, almost two‐thirds (63.6%, n = 136) used the Severity of Alopecia Tool and 38% ( n = 84) used the Dermatology Life Quality Index. Only 24.3% ( n = 52) typically tested for alternative infectious or inflammatory diagnoses, 39.7% ( n = 85) typically tested for contributory conditions such as nutritional deficiencies, and 50.9% ( n = 109) typically tested for co‐existent autoimmune illnesses. Thyroid function testing was routinely performed in 73.4% ( n = 157) and complete blood count (CBC) was checked in 65.9% ( n = 141). Compared to conventional systemic therapy, experts were more likely to check lipid levels, creatine kinase, coagulation profiles, thrombophilia screens, tuberculosis blood testing, hepatitis B and C serology before prescribing JAKi. Conclusions Real world practice of laboratory testing for AA by hair experts, who may see more severe or complex alopecia, is variable. Most experts routinely perform thyroid function and CBC testing. We discuss evidence for indications for testing for AA mimics, contributory factors, associated autoimmune conditions, and before systemic therapy. Further research is required to characterise the role of laboratory testing in AA.

JEADV Clinical PracticeVol. 4(4)
University College Dublin (IE), Brigham and Women's Hospital (US), Harvard University (US), University of British Columbia (CA), Universidade de São Paulo (BR), University of Toronto (CA), Kyorin University (JP), University of Zurich (CH), Medical University of Warsaw (PL), University College Cork (IE), Manchester Academic Health Science Centre (GB), Chelsea and Westminster Hospital NHS Foundation Trust (GB), Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College (IN), St Helens and Knowsley Teaching Hospitals NHS Trust (GB), British Thoracic Society (GB), Hospital for Sick Children (CA), Women's College Hospital (CA), Changi General Hospital (SG), Nelson Mandela Academic Hospital (ZA), Mater Misericordiae University Hospital (IE), University of Manchester (GB), Children's Health Ireland at Crumlin (IE), Yale University (US), Universidade do Estado do Rio de Janeiro (BR), South Infirmary Victoria University Hospital (IE), Woolmark (Australia) (AU), University Hospital of Zurich (CH), Sunshine Coast University Hospital (AU), Infant (IE), Salford Royal Hospital (GB), British Cardiovascular Society (GB), Azienda USL di Bologna (IT), National Cancer Registry (IE), Kaiser Permanente Vallejo Medical Center (US), Institute of Dermatology (TH), University of Minnesota Medical Center (US), SickKids Foundation (CA), Sinclair Dermatology (AU), NIHR Manchester Biomedical Research Centre (GB), Hospital Universitario Ramón y Cajal (ES), Engineering Solutions International (Ireland) (IE), Grupo ACS (Spain) (ES), New York University (US), University of Pennsylvania (US), V. N. Karazin Kharkiv National University (UA), University of Bologna (IT), Nelson Mandela University (ZA)
Canadian Institute for Theoretical Astrophysics, Wellcome Trust, Health Service Executive, National Institute for Health and Care Research, Manchester Biomedical Research Centre
Openalex Percentile: Top 84%
Hair Growth and Disorders
DOIOpen Access PDFOpenAlex
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