Alopecia Areata Research Articles

A systematic review of the efficacy of TYK2 inhibitors in patients with dermatological disease.

This study systematically reviews existing data on the efficacy of Tyrosine Kinase 2 (TYK2) inhibitors in comparison to placebo or standard treatments for therapeutic benefit and improving quality of life in dermatological diseases. Seventeen records representing 13 clinical trials, one matching-adjusted indirect comparison, and one case study were included. Results indicate that Deucravacitinib is superior to placebo, Apremilast and Adalimumab in treating adult patients with moderate-to-severe plaque psoriasis and superior to placebo in the treatment of adults with systemic lupus erythematosus. Comparative investigations on Brepocitinib and Ropsacitinib were more limited. Oral Brepocitinib demonstrated superiority over placebo in managing alopecia areata, and hidradenitis suppurativa. Topical Brepocitinib exhibited superiority over placebo in treating atopic dermatitis, but not plaque psoriasis. Ropsacitinib demonstrated superiority over placebo in the management of plaque psoriasis. Brepocitinib and Ropsacitinib had more side effects than Deucravacitinib.

Exploring Pediatric Dermatology in Skin of Color: Focus on Dermoscopy

This literature review aims to comprehensively evaluate the clinical and dermoscopic presentations of common pediatric diseases among children with skin of color (SoC) while also addressing potential variations based on racial backgrounds. This review encompasses various conditions, such as nevi subtypes, viral infections, infestations, and inflammatory dermatoses, as well as hair diseases and abnormal vascular formations, occurring in pediatric populations. Overall, we identified 7 studies on nevi subtypes, 24 studies on skin infections, 6 on inflammatory dermatoses, 10 on hair diseases and disorders, and 14 on miscellaneous disorders that also satisfied our SoC- and race-specific criteria. In case of no results, we assumed that dermoscopic findings are similar between SoC adults and children, confirming the hypothesis with our cases of dark-skinned Indian child patients. Inflammatory dermatoses such as psoriasis, eczema, and cutaneous mastocytosis, as well as skin infections like cutaneous leishmaniasis, appear with brownish backgrounds or exhibit dark structures more frequently than the respective dermoscopy images of Caucasian populations. Dermoscopy traits such as erythema in tinea capitis are uncommon or even absent on a dark-colored scalp, while a dark skin tone often obscures many characteristic features, such as dark and yellow dots in alopecia areata and even parts of an intradermal parasite in the case of scabies. Race-specific traits were also observed, such as corkscrew hair in tinea capitis, primarily seen in patients of African origin. Many dermoscopic images are consistent between SoC and non-SoC in various skin lesions, including vascular anomalies, juvenile xanthogranuloma, mastocytoma, and viral skin lesions like molluscum contagiosum, as well as in various hair disorders such as trichotillomania, while tinea capitis displays the most diverse reported dermoscopic features across SoC- and race-specific studies.

Unraveling the causal associations between systemic cytokines and six inflammatory skin diseases

BackgroundPrevious observational studies have reported that systemic cytokines are associated with the risk of inflammatory skin diseases, but their conclusions remain controversial. MethodWe conducted a two-sample Mendelian randomization analysis to assess the relationship between systemic cytokines and six inflammatory skin disorders (including alopecia areata (AA), acne, atopic dermatitis (AD), hidradenitis suppurativa (HS), psoriasis (PS) and vitiligo), based on datasets from EArly Genetics and Lifecourse Epidemiology (EAGLE) eczema consortium, acne GWAS conducted by Maris Teder Laving et al., IEU Open GWAS, and FinnGen database. Inverse-variance weighted (IVW) method was conducted in primary MR analysis, and supplemented by MR-Egger, weighted median, weighted mode, and MR-PRESSO. ResultsBy integrating the findings from both primary and sensitivity analyses, we identified ten systemic cytokines linked to the risk of six skin diseases using the IVW method. Briefly, four cytokines increased the risk of corresponding skin diseases: β-nerve growth factor (β-NGF) to AA (p = 0.005) and HS (p = 0.001), interleukin-8 (p = 0.014) to acne; interleukin-5 (p = 0.042) to AD; interleukin-13 (p = 0.049) to PS. In the meantime, seven cytokines could have protective effect on specific skin diseases: interleukin-9 (p = 0.040) and interleukin-2 receptor subunit alpha (IL-2ra) (p = 0.020) on AA; macrophage inflammatory protein (MIP)-1β (p = 0.020) on acne; monokine induced by IFN-γ (p = 0.006) on AD; interleukin-16 (p = 0.038), MIP-1β (p = 0.017) and IL-2ra (p = 0.020) on PS. ConclusionsThis study reveals 13 causal associations between systemic cytokines and 6 skin diseases, offering new perspectives on the prevention and management of widespread inflammatory skin disorders.

Hematological ratios as an indicator of severity in alopecia areata: A retrospective nationwide study.

Alopecia Areata (AA) is an autoimmune condition where the activation of Th1, Th2, and Th17 responses is known to stimulate other white blood cells, potentially affecting hematopoietic lineages. However, previous studies on AA have found no utility in hematological ratios. Our goals were to compare neutrophils-to-lymphocytes ratio (NLR), platelets-to-lymphocytes ratio (PLR), eosinophils-to-lymphocytes ratio (ELR), eosinophils-to-neutrophils ratio (ENR), and eosinophils-to-monocytes ratio (EMR) between patients with AA and controls, as well as between mild and moderate-severe AA cases. We performed a retrospective, population-based cohort study involving adult patients enrolled in the largest national health maintenance organization in Israel. The study comprised 147,020 AA patients and 141,598 healthy controls. AA patients exhibited a higher likelihood of elevated NLR and ELR compared to controls. Upon further classification based on severity, moderate-severe AA patients displayed higher values of NLR, PLR, ELR, and EMR compared to mild AA individuals OR = 1.11 [1.09-1.1], P<0.001; OR = 1.09 [1.05-1.13], P<0.001; OR = 2.06 [1.67-2.53], P<0.001; OR = 1.07 [1.03-1.07)], P<0.001, respectively). Similar trends were observed 12 to 18 months before diagnosis. Our results not only deviate from the current literature but also offer a cost-effective, accessible, and efficient tool for enhanced disease prediction and management.

Efficacy and safety of compound glycyrrhizin combined with topical minoxidil for alopecia areata: a systematic review and meta-analysis of randomized controlled trials.

Alopecia areata (AA) is a common autoimmune skin disease. Our study aimed to systematically evaluate the efficacy and safety of compound glycyrrhizin (CG) combined with topical minoxidil therapy in treating AA. We searched the PubMed, EMBASE, Cochrane Library, Web of Science, CNKI, Wanfang, and VIP databases. Randomized controlled trials (RCTs) on CG combined with topical minoxidil therapy compared with topical minoxidil therapy alone for AA were included. The Cochrane Collaborative Network Tool was used to assess the risk of bias. Statistical analysis was completed using RevMan5.3 software and Stata 15.0 software. The GRADE system was used to evaluate the quality of evidence for outcomes. 11 RCTs and 1189 patients were included. Compared with topical minoxidil therapy alone, CG combined with topical minoxidil therapy was more effective at improving the clinical efficacy (RR = 1.36, 95% CI [1.27, 1.45], p < 0.00001). The SALT score (MD = -10.09, 95% CI [-12.89, -7.30], p < 0.00001), serum TNF-α levels (MD = -0.99, 95% CI [-1.19, -0.39], p < 0.00001), serum IL-12 levels (MD = -8.84, 95% CI [-11.20, -6.47], p < 0.00001) and serum IFN-γ levels (MD = -7.44, 95% CI [-11.51, -3.37], p = 0.0003) were reduced, and the serum TGF-β1 levels (MD = 2.40, 95% CI [1.24, 3.57], p < 0.0001) were increased. There were no significant differences in reported adverse events, including irritant contact dermatitis (RR = 0.51, 95% CI [0.25, 1.01], p = 0.05),' gastrointestinal reactions (RR = 2.47, 95% CI [0.49, 12.55], p = 0.28), lower limb edema (RR = 2.60, 95% CI [0.61, 11.06], p = 0.20), facial edema (RR = 2.33, 95% CI [0.61, 8.93], p = 0.22), or localized itching (RR = 0.56, 95% CI [0.18, 1.75], p = 0.32), between the two groups. The current evidence indicates that CG combined with topical minoxidil therapy is effective and safe for AA. However, owing to the suboptimal quality of the included studies, more high-quality and large-scale RCTs are needed for comprehensive analysis and further validation.

Baricitinib inhibits the activation of innate immune cells and exerts therapeutic effects on acute peritonitis and systemic inflammatory response syndrome

Timely treatment of acute inflammatory diseases induced by bacteria or fungi is essential to prevent infectious damage. Baricitinib is an inhibitor of Janus kinases (JAKs) which was approved to treat rheumatoid arthritis, atoptic dermatitis, and alopecia areata. It is also known that JAKs play important roles in innate immunity and inflammatory response. In this study, we investigated the regulatory effects of baricitinib on the activation of macrophages and neutrophils and its therapeutic effects on acute peritonitis and systemic inflammatory response syndrome (SIRS). In addition, we also studied its anti-inflammatory mechanisms by transcriptome and immunoblotting analyses. The results showed that baricitinib inhibited the expression and secretion of multiple inflammatory factors in macrophages induced by multiple Toll-like receptor (TLR) agonists. Baricitinib also moderately suppressed superoxide release of neutrophils stimulated by TLR agonists. In zymosan-induced acute peritonitis, baricitinib significantly reduced the infiltration of neutrophils into peritoneal cavity and the production of inflammatory factors in peritoneal cavity. In addition, baricitinib also slightly decreased the production of inflammatory factors in SIRS. Transcriptome analysis revealed that baricitinib markedly inhibited the mRNA transcription of many interferon-inducible genes, antiviral immune-related genes, transcription factors in JAKs-STATs signaling pathways, inflammatory factors, chemokines, colony-stimulating factor, and immunoglobulin receptors in macrophages induced by lipopolysaccharide (LPS). Furthermore, immunoblotting analysis showed that baricitinib selectively inhibited the phosphorylation of STAT1 and STAT3 in macrophages stimulated by LPS, and almost completely blocked the phosphorylation of STAT1 and STAT3 induced by IFN-γ and IL-6. Collectively, baricitinib can moderately inhibit the activation of macrophages and superoxide production of neutrophils, and exert anti-inflammatory effects by blocking JAKs-STATs signaling pathways, and has potential to be developed into therapeutic drug for acute inflammatory diseases, especially local ones.

001 Human scalp hair follicles are protected from alopecia areata in vivo by regulatory γδT cells

001 Human scalp hair follicles are protected from alopecia areata in vivo by regulatory γδT cells

319 Novel Circulating Natural Killer Cell Subset as Biomarkers in Alopecia Areata Progression

319 Novel Circulating Natural Killer Cell Subset as Biomarkers in Alopecia Areata Progression

S116 Treatment of Concomitant Alopecia Areata and Crohn’s Disease in a Young Child With Tofacitinib: Case Report

S116 Treatment of Concomitant Alopecia Areata and Crohn’s Disease in a Young Child With Tofacitinib: Case Report

499 Possible involvement of skin resident memory T cells in refractory alopecia areata

499 Possible involvement of skin resident memory T cells in refractory alopecia areata

Effects of Petasitin as Natural Extract on Proliferation and Pathological Changes of Pediatric Neuroblastoma SK-N-SH Cells

Scalp alopecia areata (SAA) is a common non-scarring hair loss condition, associated with factors such as autoimmune responses, genetics, emotional stress, and endocrine imbalances. Current treatments for SAA included minoxidil, topical steroid creams, biologics, and plant extracts. Tea tree oil (TTO), a natural plant extract, is known for its antibacterial, anti-inflammatory, and acaricidal properties, and it also provides nourishment for hair. In this research, a natural extract of TTO, was prepared to analyze its antibacterial properties. The hair follicle stem cells (HFSCs) of patients with primary SAA were analyzed to understand the influences of TTO on migration of HFSCs. TTO was extracted from fresh tea tree leaves using steam distillation. Quantitative analysis of gas chromatography-mass spectrometry (GC/MS) qualitative analysis and its total ion chromatogram using area normalization method were conducted. Meanwhile, its antibacterial activity was tested against five common pathogens (Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), Staphylococcus albus (S. albus), Pseudomonas aeruginosa (P. aeruginosa), and Candida albicans (C. albicans)) by measuring the diameter of inhibition zones (DIZ), minimal inhibitory concentration (MIC), and minimum bactericidal concentration (MBC). HFSCs were isolated from patients with SAA and cultured in vitro, with cell identification performed through cytokeratin 15 (K15) immunofluorescent staining. The HFSCs were then exposed to varying concentrations (0.0, 0.5, 2.0, 5.0, 10.0, and 25.0 mmol/L) of TTO for culture, and cell proliferation activity (CPA) was assessed using the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) assay, while migration of HFSCs was evaluated using the Transwell chamber assay. Results demonstrated that the extracted TTO had a content of 0.69 g and an extraction rate of 2.32%. 36 components were identified, constituting 98.67% of the total, with 4-terpineol reaching a high concentration of 48.35%. It exhibited a DIZ of less than 25 mm against all tested pathogens, with MIC values lower than 29 mg/mL and MBC values below 38 mg/mL. Patients with SAA displayed yellow and black dots, broken hair, malnourished and exclamation mark hairs, with few flag hairs observed in skin microscope examination. Isolated and cultured HFSCs expressed K15 primarily in the cytoplasm and exhibited favorable growth dynamics. Treatment with various concentrations of TTO greatly increased CPA and migrated cell numbers in HFSCs, with the optimal effect observed at 5.0 mmol/L concentration of TTO. In conclusion, the plant extract TTO possessed significant antibacterial activity and can promote proliferation and migration in vitro of HFSCs, suggesting its potential therapeutic application for SAA.

023 Innate-like B cell population in the lesions of alopecia areata

023 Innate-like B cell population in the lesions of alopecia areata

Phytochemicals in hair care: A review of natural ingredients and their applications

Phytochemicals are increasingly being used in hair care products due to their potential benefits for hair growth, strength, and texture. This review article discusses the various natural ingredients used in hair care products, including herbs, essential oils, and plant extracts. The article highlights the benefits of using phytochemicals in hair care, including their ability to promote hair growth, reduce, dandruff, and improve scalp health. The review also discusses the different types of hair loss, including alopecia areata, androgenetic alopecia, and telogen effluvium. Furthermore, the article explores the various applications of phytochemicals in hair care, including their use in hair oils. Overall, this review article provides a comprehensive overview of the use of phytochemicals in hair care and highlights their potential benefits for promoting healthy hair.

Identification and characterization of alopecia areata subgroups regarding quality of life impairment based on demographic, clinical, psychological, and social factors

ABSTRACT The benign dermatological hair condition Alopecia Areata (AA) is known to impair Quality of Life (QoL), especially mental and social health, due to the accompanying visible appearance changes. Previous studies have identified demographic, clinical, social, and psychological variables related to QoL. Yet, the novelty of this study lies in examining how QoL differences in AA relate to (combinations of) these variables. The aim of the current study is to identify and characterize subgroups of AA persons with less or more QoL impairment by means of (combinations of) demographic, clinical, psychological, and social factors, including both potential risk (perceived stigmatization, avoidant coping, physical identity definition) and protective factors (disclosure, social support, emotion-focused coping and non-physical identity definition). An online questionnaire was filled out by 322 persons with AA, including the Dermatology Life Quality Index (DLQI) as QoL measure, Perceived Stigmatization Questionnaire (FSQ), brief COPE, Social Support Survey, a newly developed identity-definition measure, clinical characteristics, and demographics. Classification and Regression Tree (CART) analysis identified subgroups based on QoL outcome. Lowest QoL impairment was found in persons with low feelings of being flawed combined with low secretiveness. Low QoL impairment was also found in persons feeling flawed combined with low avoidant coping, low sensitivity to others’ opinions and older age. QoL impairment was intermediate in persons perceiving more social support in those with a younger age, and defining identity less on physical appearance in those sensitive to others’ opinions. Highest QoL impairment was characterized by feeling flawed combined with an avoidant coping style. Current findings provide indications for the identification of risk and protective profiles for QoL impairment and which factors to address in interventions to improve QoL in AA.

Clinical Profile of Patchy Alopecia: Report from a Tertiary Care Hospital of Bangladesh

Background: Patchy alopecia is a common dermatological problem worldwide with a high degree of phenotypic and genotypic variation influenced by genetic and environmental factors and is often a major source of psychological distress to patients. However, there is limited published data on patchy alopecia in Bangladesh. The purpose of this study was to evaluate the clinical pattern and prevalence of patchy alopecia in Bangladeshi patients. Materials and methods: This is a descriptive cross-sectional study which was carried out in the Department of Dermatology and Venereology of Chittagong Medical College Hospital, Bangladesh, between the periods of September 2018 to December 2019. Results: Out of 259 patients, male were 169 (65.3%) and female were 90 (34.7%) with a male to female ratio 1.8:1. The mean age of the study population was 23.73 ± 12.735 SD (Range: 1-65) years. The mean age of onset was 22.67 ± 12.735SD (Range: 0-65) years. Non Cicatricial Alopecia (NCA) were accounted 192 (74%) and rest of the 67 (26%) were Cicatricial Alopecia (CA) patients. Alopecia Areata (AA) 172 (66.4%) was the most common 192 (74%) NCA while alopecia due to Discoid Lupus Erythematosus (DLE) 34(13.1%) was the most common 67 (26%) CA. Most of the patients 158 (61%) had multiple patches. Among 259 patients, 77 (29.73%) patients had associated pruritus, 44 (16.98%) patients had scaling and 49 (18.9%) patients were atopic. Conclusion: This study finding showed that patchy hair loss results from a variety of causes. Proper identification and differentiation of pattern of patchy alopecia is necessary for early diagnosis and to design appropriate treatment and by all these means to improve the quality of life Chatt Maa Shi Hosp Med Coll J; Vol.22 (2); July 2023; Page 27-30

Applications and efficacy of minoxidil in dermatology.

Minoxidil, originally developed as an antihypertensive medication, has evolved into a versatile therapeutic agent within dermatology, notably for its effectiveness in promoting hair growth. Despite its widespread use, understanding its precise mechanism of action remains a challenge. This paper addresses this gap by providing a comprehensive review of pharmacological properties, action mechanisms, clinical effectiveness and side effects associated with topical minoxidil. Furthermore, it highlights emerging trends and applications, including its role in treating androgenetic alopecia, its potential for alopecia areata management and its utilization in combination therapies. Additionally, this paper explores novel applications in scar treatment and wound healing. By synthesizing current knowledge and insights, this review adds clarity to the diverse applications of minoxidil, providing valuable guidance for clinicians and researchers aiming to optimize its therapeutic use in dermatology.

Management of Indralupta with Pracchana- A Case Study

ndralupta is one among the shiro kapalagata roga. According to Acharya Vagbhatta, pitta along with vata invades the romakoopa causes hairfall. Vitiation of Sleshma along with shonita obstructs the channels of Romakoopa leading to the stoppage of regrowth of hair1. This condition is known as Indralupta. Indralupta can be correlated with Alopecia areata in which there is a sudden hairfall that strarts with one or more circular bald patches. In Ayurveda both shodhana and shamana treatments are prescribed for Indralupta. This is a case report of 25 year old male patient complaints of patchy hair loss and thinning of hair since 2 months. Materials and Methods: The subject who approached Shalakya tantra opd of SDM Ayurveda hospital Udupi with symptoms of patchy hair loss and thinning of hair since 2 months was systematically reviewed and treatment modalities like pracchana and internally Arogyavardhini rasa, Tiktaka kashaya, Saptamruta loha and Bhargava prokta rasayana is advised. Results: The subject showed marked improvement symptomatically. Discussion: Ayurveda has great approach in curing the Indralupta. Nidana parivarjana, shamanoushadis and external applications are the main treatment modalities which can be concluded from this case report.

Dupilumab: Evaluating its role in atopic dermatitis, prurigo nodularis, eczemas, urticaria, alopecia areata and vesiculobullous disorders – Part I

Dupilumab is a fully human monoclonal IgG4 antibody that targets IL-4 and IL-13 signaling pathways. It is approved by the US-FDA for the treatment of atopic dermatitis and prurigo nodularis. Besides, it has shown efficacy in various off-label dermatologic conditions. Part I of this review will elaborate on the utility of dupilumab in atopic dermatitis, prurigo nodularis, eczemas, urticaria, alopecia areata and vesiculobullous disorders.

Comparative Efficacy and Safety of Baricitinib Against Traditional Therapies in Severe Alopecia Areata: ARetrospective Cohort Study.

Alopecia areata is a common autoimmune disease which results in reversible hair loss. Janus kinase inhibitors are prescribed for severe alopecia areata with encouraging results. There are no studies comparing the efficacy and safety of Janus kinase inhibitors to traditional treatment options, such as topical immunomodulators and traditional immunosuppressants. To retrospectively compare the efficacy and safety of baricitinib, an approved Janus kinase inhibitor, to other treatments for severe AA during a 6-month treatment period. We included patients with newly presenting, relapsing or treatment-resistant alopecia areata with Severity of Alopecia Tool (SALT) score ≥ 50, for the period between July 2021 and July 2023. Medical histories were reviewed and possible side effects were recorded. Primary endpoints were SALT ≤ 20 and SALT ≤ 10 after 6 months of treatment. Seventy-five patients (53 females) were divided into three groups: topical immunomodulators (51 patients); baricitinib (19 patients); and a group receiving pulsed intramuscular corticosteroids or traditional immunosuppressants (11 patients). Twenty-one patients received more than one treatment options within 2 years. After 6 months, the baricitinib group showed superior efficacy with 32% and 26% of patients achieving SALT ≤ 20 and SALT ≤ 10, compared to 12% and 9% in both other groups. Baricitinib demonstrated better secondary outcomes (50% and 90% reduction from initial SALT scores). All treatments exhibited mild-to-moderate and expected side effects. Weight gain, which had not been reported in clinical trials for alopecia areata, was observed in three baricitinib-treated patients. Baricitinib was superior to traditional treatments for severe alopecia areata after 6 months. Weight gain concerned 16% of patients receiving baricitinib.

Demographics and Disease Characteristics of Patients with Alopecia Areata with Comorbid Atopic Dermatitis, Vitiligo or Anxiety/Depression: TARGET-DERM AA

Introduction Alopecia areata (AA) is a chronic autoimmune disease. Common AA comorbidities include atopic dermatitis (AD), vitiligo, anxiety and depression (AnxDep). TARGET-DERM AA is an ongoing longitudinal, real-world study of United States and Canadian AA patients. The purpose of this analysis is to assess characteristics among AA patients with and without the above comorbidities. Methods At enrollment (December 2021-June 2024), patients reported outcomes (including comorbidities, Patient Global Impression of Severity-AA, and clinician-reported outcome measures: Severity of Alopecia Tool, Measure for Eyebrow/Eyelash Hair Loss). Characteristics were compared across subgroups. Results Of the 267 AA patients with completed patient questionnaires at enrollment, 61.4% were female; 24.4% were aged &lt;12 years, 13.7% 12-17, and 61.7% 18 or older. Overall, 21.0% self-reported an AD diagnosis (19.7% of pediatric, 11.1% of adolescent, and 25.4% of adult AA patients), 7.1% vitiligo (7.0% of pediatric, 3.7% of adolescent, and 8.5% of adult AA patients) and 44.9% AnxDep (21.1% of pediatric, 40.7% of adolescent, and 58.5% of adult AA patients). 42.1% of patients with comorbid vitiligo had severe AA disease (SALT&gt;50) and 27.8% patients without comorbid vitiligo had SALT&gt;50. 28.6% of those with comorbid AD had SALT&gt;50 compared to 28.9% of those not reporting AD, with 30.0% of AnxDep and 27.9% of non-AnxDep having SALT&gt;50, all p&gt;0.2. 42.1% of patients with comorbid vitiligo reported PGIS-AA ‘severe/very severe’ disease, with 41.1% of patients with comorbid AD and 42.5% of patients with comorbid AnxDep reporting severe/very severe AA disease, all numerically higher than patients without comorbid vitiligo (36.3%), AD (35.6%), and AnxDep (31.9%), all p&gt;.07. Among those with and without vitiligo, 42.1% vs 37.9% had eyebrow involvement, 36.8% vs 30.2% eyelash; considering AD, 35.7% vs 38.9% had eyebrow involvement, 28.6% vs 31.3% eyelash; for AnxDep 39.2% vs 37.4% had eyebrow involvement, 30.8% v 30.6% eyelash, all p&gt;0.5. Discussion In this real-world cohort of AA patients, the presence of specific comorbidities was not associated with statistically significant differences in clinician reported AA severity, eyebrow or eyelash involvement. Comorbid AnxDep was associated with increased patient-reported AA disease severity. Additional research characterizing how dermatologic and psychiatric comorbidities impact health-related quality of life and patient burden has the potential to inform management decisions.