Alopecia areata investigational assessment guidelines*

Abstract

From Duke University Medical Center, Durhama; University of Minnesota, Minneapolisb; Pontefract General Infirmaryc; University of California at San Franciscod; Northwest Cutaneous Research Specialists, Portlande; The University of British Columbia, Vancouverf; and Johnson & Johnson, Skin Biology Research Center, Skillman.g Reprint requests: Elise A. Olsen, MD, Professor of Medicine, Duke University Medical Center, Box 3294, Durham, NC 27710. J Am Acad Dermatol 1999;40:242-6. *Developed from the Alopecia Areata Consensus meeting sponsored by the National Alopecia Areata Foundation at the First Tricontinental Meeting of the Hair Research Societies, Brussels, Belgium, Oct 8, 1995. Participants are listed at the end of the guidelines. Copyright © 1999 by the American Academy of Dermatology, Inc. 0190-9622/99/$8.00 + 0 16/1/95940 I. PURPOSE To establish criteria for selecting and assessing subjects for both clinical and laboratory studies of alopecia areata, thereby facilitating collaboration, comparison of data, and the sharing of patient-derived tissue II. DEFINITION OF ALOPECIA AREATA Alopecia areata is a dermatologic disease characterized in its limited form by circumscribed round or oval patches of alopecia with well-demarcated borders between normal and affected scalp. There is no scale or induration of the scalp and no loss of follicular markings. Disease extent may progress from this limited form to complete loss of hair on the scalp and/or body. III. INCLUSION CRITERIA These guidelines apply only to terminal hair loss or growth on the scalp. These guidelines focus on the major forms of alopecia areata (patchy alopecia areata, alopecia totalis, and alopecia universalis) and their expression on the scalp. The terms alopecia totalis and alopecia universalis imply 100% scalp hair loss. Areas of hair loss other than on the scalp may be assessed and documented in the data collected on each patient. (See Section IV. B) IV. CRITERIA FOR MEASURING EXTENT OF INVOLVEMENT Those data items in boldface type should be filled out in toto. Those data items not in bold are optional and can be filled out as desired by the investigator. A. The proportion of scalp involvement is determined by dividing the scalp into 4 quadrants and estimating the percentage of the scalp surface that all the alopecic areas would occupy if placed together. The following groups will be used: S: Scalp hair loss _____S0 = No hair loss _____S4 = 76%-99% hair loss _____S1 = ≤ 25% hair loss _____a = 76%-95% hair loss _____S2 = 26%-50% hair loss _____b = 96%-99% hair loss _____S3 = 51%-75% hair loss _____S5 = 100% hair loss B. Other areas of alopecia or involvement by alopecia areata may be noted: B: Body hair loss _____B0 = No body hair loss _____B2 = 100% body (excluding scalp) hair loss _____B1 = Some body hair loss N: Nail involvement _____N0 = No nail involvement _____N1 = Some nail involvement _____a. Twenty-nail dystrophy/trachyonychia (must be all 20 nails) SPECIAL ARTICLE