Alopesi areatalı olgularda ve yakınlarında kötü prognostik faktörlerin incelenmesi. (Turkish)

Background and Design: Alopecia areata (AA) is characterized by non-ciatricial hair loss with exacerbations and remissions. Although its etiopathogenesis is not known, autoimmune factors have been suggested. Our aim was to make contribution to the epidemiological properties of AA in Turkey, and to determine the poor prognostic factors that affect the course of the disease. Materials and Methods: One hundred and thirty-four patients who applied to the dermatology and venereology outpatient clinic of Istanbul Medical Faculty were included in the study. The patients were retrospectively investigated in terms of age, gender, clinical type, the area affected by alopecia, severity of the disease, number of relapses, disease duration, age at disease onset, presence of nevus flammeus, nail involvement, history of emotional and/or physical stress, family history of AA, family and personal history of atopy. Results: Of the 134 patients, 79 (59 percent) were male, 55 (41 percent) were female and M/F ratio was 1.4/1. The clinical type was AA in 86.5%, alopecia totalis (AT) in 3.7% and alopecia universalis (AU) in 9.7% of the cases. The most common involvement was the scalp in both genders and 92.1% of them had patch pattern. Severe involvement was found to be significant in the female patients (p=0.029), in those with juvenile onset (p=0.001), and ≥1 year of disease duration (p=0.001) as well as in the presence of nevus flammeus (p=0.017) and nail involvement (p=0.015). A family history of AA was present in 27.6% of the cases and it was more common in the juvenile group (p=0.034). There was no association between the severity of the disease and atopy. Conclusion: AA follows a more severe course in female patients and in patients with juvenile onset, nail involvement, nevus flammeus, long disease duration, and a family history of AA than in others. [ABSTRACT FROM AUTHOR]

Amaç: Alopesi areata (AA), skar yapmayan saç kaybı ile alevlenme ve remisyonlarla seyreden bir hastalıktır. Etyopatogenezi tam olarak bilinmemekle beraber otoimmün hipotez üzerinde durulmaktadır. Alopesi areata olgularının klinik ve demografik özellikleri incelenerek Türkiye’de AA’nın epidemiyolojik özelliklerine katkı sağlanması ve hastalık seyrine etkili kötü prognostik faktörlerin ortaya konulması amaçlandı. Gereç ve Yöntem: İstanbul Üniversitesi, İstanbul Tıp Fakültesi Deri ve Zührevi Hastalıkları Anabilim Dalı polikliniğine başvurmuş 134 hasta çalışmaya alındı. Hastalar yaş, cinsiyet, klinik tip, alopesi tutulum alanı, hastalık şiddeti, atak sayısı, hastalık süresi, hastalık başlangıç yaşı, nevus flammeus varlığı, tırnak tutulumu, emosyonel ve/veya fiziksel stres öyküsü, ailede AA öyküsü, ailede ve hastada atopi öyküsü açısından retrospektif olarak incelendi. Bulgular: Çalışmaya alınan 134 hastanın 79'u erkek (%59), 55'i kadın (%41), erkek: kadın oranı 1.4:1, klinik olarak %86,5 AA, %3,7 alopesi totalis (AT), %9,7 alopesi universalis (AU) idi. Her iki cinste en sık saçlı deri tutulumu vardı ve bunların %92,1'i (n=93) yama paterninde idi. Şiddetli tutulum; kadınlar (p=0,029), juvenil başlangıç (p=0,001), ≥1 yıl hastalık süresi (p=0,001), nevus flammeus varlığı (p=0,017) ve tırnak tutulumunda (p=0,015) istatistiksel olarak anlamlı bulundu. Olguların %27,6'sında ailede AA hikayesi vardı ve juvenil grupta yüksek idi (p=0,034). Hastalık şiddeti ile atopi arasında ilişki yoktu (p>0,05). Sonuç: Alopesi areata; kadınlar, juvenil başlangıç, tırnak tutulumu, nevus flammeus varlığı, uzun hastalık öyküsü, ailede AA hikayesinde şiddetli seyretmektedir. [ABSTRACT FROM AUTHOR]

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