Health‐Related Quality of Life Among Adult Patients With Alopecia Areata in Brazil: Real‐World Patient‐Reported Outcomes Assessed by EQ‐5D and SKINDEX‐16 AA

ABSTRACT Background Alopecia areata (AA) is an autoimmune disease characterized by patchy or complete nonscarring hair loss on the scalp, face, and/or body, leading to substantial impairment in health‐related quality of life (HRQOL). Real‐world data on the impact of AA on HRQOL are limited in Brazil. Objectives To investigate the demographics, clinical characteristics, and HRQOL among Brazilian patients with AA. Methods A cross‐sectional survey of dermatologists and their adult patients with AA was conducted from March–June 2024 in Brazil. Data included demographics, clinical characteristics, SKINDEX‐AA, and EQ‐5D‐5L scores. Bivariate analyses compared patients with < 50% vs. ≥ 50% scalp hair loss (SHL). Results Among 279 patients, 198 had < 50% SHL and 81% ≥ 50% SHL. Full‐time employment was lower among patients with ≥ 50% vs. < 50% SHL (51.3% vs. 67.5%; p = 0.0089). Those with ≥ 50% SHL had a longer time since diagnosis (mean [SD], 1445.4 [2413.6] vs. 713.2 [1314.0] days; p = 0.0043), more frequent disease worsening (slow, 21.0% vs. 14.1%; p = 0.0027; rapid, 11.1% vs. 4.5%; p = 0.0027), and significantly lower percentage of scalp hair regrowth (mean [SD], 31.8 [18.5] vs. 46.1 [34.6]; p = 0.0300). Hair loss across other body sites was more common in patients with ≥ 50% SHL. Mean (SD) SKINDEX‐16 AA scores were higher in patients with ≥ 50% vs. < 50% SHL (overall, 63.4 [15.7] vs. 34.2 [21.9], p = 0.0001; emotions, 83.0 [19.2] vs. 44.1 [28.0], p < 0.0001; functioning, 67.4 [29.6] vs. 35.6 [27.7], p = 0.0017), whereas EQ‐5D‐5L scores did not differ significantly. Limitations This study utilized a convenience sample, sampling was based on the next “ n ” eligible patients, and the study data were self‐reported and may be subject to recall bias. Conclusions In Brazil, more extensive SHL was associated with more severe AA and greater HRQOL impairment, as measured by SKINDEX‐16 AA. These findings underscore the importance of timely diagnosis and access to efficacious therapies, particularly for those with more severe AA.