Rethinking The Classification Of Alopecia Areata

    February 2019 in “ Journal of the American Academy of Dermatology ”
    Carlos Gustavo Wambier, Brett King
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    TLDR The document concludes that a new system using the SALT score should replace the current alopecia areata classification for better accuracy in assessing severity and prognosis.
    The document suggests that the current classification of alopecia areata (AA), which includes patchy alopecia, ophiasis, alopecia totalis (AT), and alopecia universalis (AU), is insufficient and does not correlate well with prognosis. The authors propose a new classification system that uses the Severity of Alopecia Tool (SALT) score, which objectively measures the extent of hair loss from 0% to 100%, along with the presence or absence of body hair involvement. This system would replace subjective judgments and provide a more precise assessment of AA severity, which is important for both clinical trials and treatment approaches. The document emphasizes the need for a classification that has clinical and prognostic value, especially in light of new treatments like Janus kinase inhibitors and the potential for payers to adopt severity scales based on the SALT score.
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