Abstract
Introduction
Alopecia areata (AA) is the most common form of immune-mediated hair loss. Studies have begun to establish the most frequent comorbid diseases of AA; however, results have been inconsistent with few prospective studies.
Methods
A total of 63,692 women in the Nurses’ Health Study, 53–80 years, were prospectively followed from 2002 to 2014 to determine whether history of immune-mediated disease was associated with AA risk. Hazard ratios (HRs) and 95% confidence intervals (CIs) for AA in relation to immune-mediated conditions were computed using Cox proportional hazard models, adjusted for AA risk factors.
Results
133 AA cases were identified during follow-up. Personal history of any immune-mediated disease was associated with increased AA risk (HR 1.72, 95% CI 1.24–2.37). History of systemic lupus erythematosus (HR 5.43, 95% CI 2.11–13.97), multiple sclerosis (HR 4.10, 95% CI 1.40–11.96), vitiligo (HR 3.13, 95% CI 1.08–9.10), psoriasis (HR 2.01, 95% CI 1.00–4.03), hypothyroidism (HR 1.88, 95% CI 1.30–2.71), and rheumatoid arthritis (HR 1.66, 95% CI 1.09–2.52) were associated with increased AA risk. History of inflammatory bowel disease or Graves’ disease/hyperthyroidism was not significantly associated with AA risk.
Conclusions
In this prospective study, personal history of immune-mediated diseases either individually or overall was associated with increased AA risk.
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Data availability
The data of this study are available upon reasonable request. Further information including the procedures to obtain and access data from the Nurses’ Health Studies is described at https://www.nurseshealthstudy.org/researchers (contact e-mail: nhsaccess@channing.harvard.edu).
Abbreviations
- NHS:
-
Nurses’ Health Study
- HR:
-
Hazard ratio
- CI:
-
Confidence interval
- AA:
-
Alopecia areata
- RA:
-
Rheumatoid arthritis
- IBD:
-
Inflammatory bowel disease
- SLE:
-
Systemic lupus, vitiligo
- MS:
-
Multiple sclerosis
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Acknowledgements
The authors would like to acknowledge the contribution to this study from central cancer registries supported through the Centers for Disease Control and Prevention’s National Program of Cancer Registries (NPCR) and/or the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program. Central registries may also be supported by state agencies, universities, and cancer centers. Participating central cancer registries include the following: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Iowa, Kentucky, Louisiana, Massachusetts, Maine, Maryland, Michigan, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, Seattle SEER Registry, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wyoming.
Funding
This work was funded by National Institutes of Health (NIH) Grant UM1 CA186107 and Pfizer Investigator Sponsored Research (ISR) grant.
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Conceptualization: EC, EAG, JMT; formal analysis: EC, JHK; writing—original draft: IHM, EAG, JMT, SDR; writing—editing: IHM; JMT; EAG; SDR; JHK; AMR; AQ; EC.
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The study protocol was approved by the institutional review boards of the Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health, and those of participating registries as required.
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Moseley, I.H., Thompson, J.M., George, E.A. et al. Immune-mediated diseases and subsequent risk of alopecia areata in a prospective study of US women. Arch Dermatol Res 315, 807–813 (2023). https://doi.org/10.1007/s00403-022-02444-x
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DOI: https://doi.org/10.1007/s00403-022-02444-x