Assessment of Clinician-Reported Outcome Measures for Alopecia Areata: A Systematic Scoping Review

August 2024 in “ Clinical and Experimental Dermatology ”

Emadodin Darchini‐Maragheh, Anthony Moussa, Huw Rees, Leslie N. Jones, Laita Bokhari, Rodney Sinclair

alopecia areata ClinROMs scalp hair loss disease activity nonscalp areas clinical severity scoring system AA

Studysummary This review discusses the limitations of existing clinician-reported outcome measures for alopecia areata and emphasizes the need for a composite scoring system to better assess disease severity.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

This systematic scoping review identifies and evaluates 16 clinician-reported outcome measures (ClinROMs) for assessing alopecia areata (AA) severity, highlighting the lack of consensus on the most appropriate tool. The study reviewed 14 articles from a pool of 1376, focusing on ClinROMs that measure scalp hair loss, disease activity, and nonscalp areas. The review underscores the practical limitations of existing tools, which hinder their widespread use in clinical practice. The authors conclude that there is a significant need for a comprehensive clinical severity scoring system that encompasses all key severity indicators, not just scalp involvement.

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research The Alopecia Areata Severity And Morbidity Index (ASAMI) Study

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This review discusses recent advances in understanding and treating alopecia areata, emphasizing the ongoing challenges and unmet needs in disease management; it reports no new clinical findings.

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September 2022 in “Journal of Investigative Dermatology”

This study found that the Severity of Alopecia Tool score does not predict the quality of life in patients with alopecia areata, suggesting patient-reported outcomes better reflect the impact on life quality.

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research The Epidemiology of Alopecia Areata: A Population-Based Cohort Study in UK Primary Care

117 citations , July 2021 in “British Journal of Dermatology”

This study reports that the incidence of alopecia areata is 0.26 per 1000 person-years in the UK, with higher rates among Asian ethnic groups, socially deprived populations, and urban residents.

research Development and Validation of the Brigham Eyelash Tool for Alopecia: A Measure of Eyelash Alopecia Areata

6 citations , March 2021 in “Journal of the American Academy of Dermatology”

This study found that the Brigham Eyelash Tool for Alopecia (BELA) is a reliable measure for assessing eyelash loss in alopecia areata patients, demonstrating high inter- and intrarater reliability.

research Brigham Eyebrow Tool for Alopecia: A Reliable Assessment of Eyebrow Alopecia Areata

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The Brigham Eyebrow Tool for Alopecia is a simple and reliable way to measure eyebrow hair loss.

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research Development of Clinician-Reported Outcome and Patient-Reported Outcome Measures for Eyebrow, Eyelash, and Nail Assessment in Alopecia Areata

56 citations , August 2020 in “American Journal of Clinical Dermatology”

This study concluded that the ClinRO and PRO measures, along with their photoguides, offer clear and meaningful assessments for patients with alopecia areata concerning eyebrow, eyelash, and nail appearance, as well as eye irritation.

research The Alopecia Areata Investigator Global Assessment Scale: A Measure for Evaluating Clinically Meaningful Success in Clinical Trials

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This study developed the Alopecia Areata Investigator Global Assessment (AA-IGA) to measure scalp-hair loss in alopecia areata patients, incorporating perspectives of both patients and clinicians to define treatment success.

research Alopecia Areata Predictive Score: A New Trichoscopy-Based Tool to Predict Treatment Outcome in Patients with Patchy Alopecia Areata

19 citations , July 2019 in “Journal of Cosmetic Dermatology”

This study found that in patients with patchy alopecia areata, certain trichoscopic features like upright regrowing hairs and pigtail hairs are positive predictive markers for treatment success.

research Nail Changes in Alopecia Areata: An Update and Review

45 citations , January 2018 in “International Journal of Dermatology”

This review explores nail changes associated with alopecia areata, noting their prevalence and impact on appearance and function, but reports no new clinical findings; the authors call for larger controlled trials.

research Objective Outcome Measures: Collecting Meaningful Data on Alopecia Areata

39 citations , November 2017 in “Journal of The American Academy of Dermatology”

This review presents standardized methods for assessing and tracking hair loss in alopecia areata but reports no clinical results, with the authors noting time limitations in clinical practice.

research Hair Pull Test: Evidence-Based Update and Revision of Guidelines

36 citations , December 2016 in “Journal of The American Academy of Dermatology”

In this study, researchers evaluated the hair pull test and found that normal values should be reduced to two hairs or fewer, with no significant impact from hair washing, brushing, or lifestyle factors such as hair texture and medication use.

research SALT II: A New Take on the Severity of Alopecia Tool for Determining Percentage Scalp Hair Loss

44 citations , November 2016 in “Journal of The American Academy of Dermatology”

This article updates a diagnostic tool (SALT II) for assessing hair loss by adding more precise measurements of scalp surface area, particularly useful for various types of alopecia.

research Alopecia Areata and Health-Related Quality of Life: A Systematic Review and Meta-Analysis

128 citations , February 2016 in “British Journal of Dermatology”

This study found that patients with alopecia areata experience significant impairments in health-related quality of life, notably affecting mental health, according to various quality of life assessment tools.

research Multivariate Analysis of Prognostic Factors in Patients With Rapidly Progressive Alopecia Areata

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This study observed that patients with rapidly progressive alopecia areata may have a favorable prognosis regardless of treatment, and regenerated vellus hairs were linked to higher improvement or cure rates.

research Clinical Severity Does Not Reliably Predict Quality of Life in Women With Alopecia Areata, Telogen Effluvium, or Androgenic Alopecia

86 citations , May 2011 in “Journal of The American Academy of Dermatology”

This study found that patients with alopecia perceive their hair loss as more severe than dermatologists do, and their own ratings of hair loss severity better reflect their quality of life impacts.

research Coudability Hairs: A Revisited Sign of Alopecia Areata Assessed by Trichoscopy

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In this study, coudability hairs were identified as a useful marker for assessing disease activity in patients with alopecia areata and may serve as an alternative to the hair-pull test.