459 Screening for hearing loss in pediatric alopecia areata

Abstract

Hearing loss has been reported for adults with alopecia areata at higher frequencies than controls. We performed a prospective study of pediatric patients with alopecia to assess risk for hearing loss with emphasis on sensorineural hearing loss. We included 50 children ages 4-12 years of age with alopecia areata with severity greater than 50% and with at least 6 months of disease and tested hearing using standard pure tone audiometry and otoacoustic emission testing. Testing results suggest that hearing screens should be part of clinical care for children with alopecia areata with greater than 50% severity. We hypothesize immune mediated targeting of melanocytes in the hair follicles and inner ear plays a role in this type of hearing loss. Melanocytes play a key role in auditory stimuli transduction and modulation in the inner ear. Since this type of hearing loss is permanent is it important to consider whether we should be more aggressive with systemic therapies in children with severe forms of alopecia areata to prevent these changes. This study once again highlights that alopecia areata is a medical disease and the effects of having this disease are more than cosmetic.