Severe Psychological Impact Research Articles

Epidemiological and Trichoscopic Study of Patchy Scalp Alopecia in Children in Delta Egypt

Abstract Background Alopecia represents a distressing problem among children and has a severe psychological impact on the affected patients and their parents. Objective To investigate the clinical presentations of patchy hair loss and analysis of their prevalence and trichoscope features in children in delta Egypt. Methods The study was done on 374 patients aged from 0-18 years (231 males, 143 females) with patchy hair loss who were subjected to detailed history taking, dermatological examination as regard the patch of alopecia, scalp skin, nails, teeth, in addition to trichoscopic examination. The obtained demographic and clinical data of the included patients were tabulated and statistically analyzed. Results Mean age 7.77 years, 231 (61.8%) male patients and 143 (38.2%) female patients. Hair loss in children in this study is largely non-cicatricial causes; specifically alopecia areata, followed by infectious causes; specifically scaly tinea capitits (141 patients). The total number of patients having non-infectious alopecia was 206 patients. Alopecia areata was present in 147 patients (39.3%), toxic alopecia (post folliculitis) (12.6%), trichotillomania (2.1%), and congenital alopecia. Male preponderance in cicatricial alopecia, toxic alopecia (post folliculitis) and infectious disease groups versus female preponderance in non-cicatricial alopecia, alopecia areata, trichotillomania, patchy traction alopecia. The age groups with the largest numbers of children were those school age children aged five to ten years representing (50.5%). Alopecia presented from rural areas represents (72.5%). Trichoscope examination have confirmed the dermatologic clinical diagnosis of patchy alopecia in 368 patients. Conclusion The largest number of children presenting with patchy alopecia in Delta Egypt were those of school age children aged five to ten years, living in rural areas. Hair loss in children is largely due to alopecia areata followed by tinea capitits. Detection of specific trichoscopic features of each disease is mandatory for the accurate diagnosis and proper differentiation of -sometimes- confusing cases of hair and scalp disorders.

Psychological Fallout of Sexual Harassment on Women across Various Social Contexts

Sexual harassment (SH) poses a significant threat to mental health, causing profound emotional distress, particularly among women. Despite legal frameworks, the psychological consequences of SH are inadequately addressed. This study examines the prevalence, manifestations and effects of SH through a structured literature review, using sources such as Google Scholar, PsycINFO and PubMed for articles published after 2018 on the psychological effects of SH. The review process included initial screening based on relevance and quality, methodological evaluation and narrative synthesis. The findings reveal SH’s severe psychological impact across various settings, including workplaces, educational institutions and intimate relationships, with consequences like fear, anxiety, shame, depression and confidence erosion. Reluctance to report SH further exacerbates the psychological toll. The study highlights the need for comprehensive strategies, recommending accessible mental health services, educational campaigns and stronger policies. Fostering a culture of respect, equality and inclusion can enhance survivors’ well-being and create a supportive environment.

Severity and Clinical Outcomes of Pediatric Burns-A Comprehensive Analysis of Influencing Factors.

(1) Background: Burn injuries in children present a significant public health concern due to their potential for severe physical and psychological impact. (2) Methods: This study investigates the determinants of pediatric burn severity by analyzing the interplay of demographic and environmental factors. Through a retrospective analysis of pediatric burn cases over five years, encompassing patient demographics, burn causative agents, and clinical outcomes, this research aims to identify significant predictors of burn severity. (3) Results: This study presents a comprehensive analysis of pediatric burn injuries, focusing on the severity, clinical outcomes, and multifactorial aspects influencing recovery. We reviewed 1498 pediatric burn cases from January 2015 to December 2020. The mean age of patients was 5.8 years, with a slight male predominance (54%). Scalds (45%), flame burns (30%), and contact burns (15%) were the most common burn types. Our findings indicate significant differences in burn severity based on TBSA, with 32.5% of cases having TBSA greater than 20%. Multivariate logistic regression identified rural residence, male gender, flame burns, and lower socioeconomic status as significant predictors of severe burn outcomes. The overall mortality rate was 2.5%, with higher rates among patients with TBSA greater than 40%. These results highlight the need for targeted prevention strategies and improved access to specialized burn care. (4) Conclusions: Understanding these factors can inform targeted prevention strategies and improve treatment protocols.

The Mechanisms of Adipose Stem Cell-Derived Exosomes Promote Wound Healing and Regeneration.

Chronic wound healing is a class of diseases influenced by multiple complex factors, causing severe psychological and physiological impact on patients. It is an intractable clinical challenge and its possible mechanisms are not yet clear. It has been proven that adipose stem cell-derived exosomes (ADSC-Exos) can promote wound healing and inhibit scar formation by regulating inflammation, promoting cell proliferation, migration, and angiogenesis, regulating matrix remodeling, which provides a new approach for wound healing through biological treatment. This review focuses on the mechanism, treatment, and administration methods of ADSC-Exos in wound healing, providing a comprehensive understanding the mechanisms of ADSC-Exos on wound healing. LEVEL OF EVIDENCE I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Adolescent Pregnancy in Indonesia Leads to Severe Psychological Impact

Adolescents are particularly vulnerable to unwanted pregnancies, leading to significant psychological impacts. This study explores the psychological effects of pregnancy on 15-18-year-old adolescents, focusing on a 17-year-old case study. Using in-depth interviews and the DASS 42 scale, we found that pregnancy in adolescents leads to depression, anxiety, and stress, affecting both the individual and their environment. The subject experienced familial neglect and initial denial, attempted to terminate the pregnancy, but ultimately accepted it with family and partner support. The findings highlight the need for robust support systems and preventive education to address adolescent pregnancy's psychological challenges. Highlight: Adolescent pregnancy causes severe depression, anxiety, and stress. Family and partner support is crucial for coping. Preventive education is essential for reducing psychological distress. Keyword: dolescent pregnancy, psychological impact, depression, anxiety, stress

An investigation of the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer: a randomized controlled trial

BackgroundBreast cancer is an extremely unpleasant and unbearable experience that can have a profound impact on a person’s life. Compared to other types of cancer, breast cancer has a more severe psychological impact on women.PurposeThis study aimed to investigate the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer.MethodA sample of 30 women with breast cancer were randomly divided into intervention and control groups. The research was conducted in the oncology division of Imam Reza Hospital in Kermanshah by the clinical trial method with a two-group pretest–posttest design and a 2 month follow-up. Participants in the intervention group received Mindfulness-integrated cognitive behavior therapy for eight sessions. The intervention was carried out individually in weekly 60 min sessions. While the control group received self-help treatment (through an educational book). A demographic questionnaire, Demoralization Scale (DS-II), Body Image Scale (BIS), and Female Sexual Function Index (FSFI) were used to collect data. For data analysis, means and standard deviations were calculated and repeated measures and the Bonferroni test was conducted using SPSS 26.ResultsThe results showed the effectiveness of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function (p < 0.05). Concerning demoralization in the intervention group, the pre-test mean was 16.73 ± 3.33, and it reduced to 11.93 ± 1.49 in the post-test. The body image mean score showed a decreasing trend in the intervention group, from 12.47 ± 1.88 in the pre-test to 8.80 ± 3.21 in the post-test. The mean score for sexual function showed an increasing trend, increasing from 18.06 ± 2.29 in the pre-test to 23.07 ± 0.91 in the post-test. There was no significant difference in the mean score of the post-test compared to the pre-test and follow-up in the control group (p < 0.05).ConclusionMICBT can be used in conjunction with pharmaceuticals and medical treatments to improve the psychological symptoms of women with breast cancer, according to this study’s results.Trial registration (IRCT20160103025817N6). 2022-04-06.

LetibotulinumtoxinA Attenuates the Psychological Burden of Glabellar Lines and Is Associated With High Subject Satisfaction in Phase 3 Clinical Trials.

Hyperfunctional glabellar frown lines can transmit facial miscues that adversely affect emotional communication, increase perceptions of age, and diminish self-esteem. To evaluate the efficacy of letibotulinumtoxinA in mitigating the negative psychological impact associated with moderate to severe glabellar lines and to assess subject satisfaction with treatment outcome in the BLESS phase 3 clinical trials. Baseline and posttreatment assessments were made using validated subject-administered instruments: Modified Skindex-16 Glabellar Line Quality of Life (GL-QoL) Scale, Facial Assessment and Cosmetic Evaluation Questionnaire (FACE-Q) Appraisal of Lines Between Eyebrows Scale, FACE-Q Age Appraisal Visual Analog Scale, and FACE-Q Satisfaction with Outcome Scale. An integrated analysis using pooled BLESS data was conducted on these secondary end points. Among enrolled and treated subjects ( N = 1,272), 85.5% had moderate to severe psychological impact at baseline. LetibotulinumtoxinA subjects experienced significant improvements compared with placebo on all measures. Mean improvement to Week 4 for the Modified Skindex-16 GL-QoL Scale overall score was -33.84 for letibotulinumtoxinA subjects compared with -1.37 for placebo subjects ( p < .001). Attenuation of psychological burden was highly correlated with improvement in glabellar line severity ( p < .0001). LetibotulinumtoxinA significantly improved the psychosocial burden associated with glabellar lines across all trials. Treated subjects experienced improved quality of life, younger perceived age, and satisfaction with treatment outcome.

Retrospective Analysis of COVID-19 Impact on Social + Emotional Development in Children of Low-Income Communities from Head Start

Background:Geminus Head Start is a federal program that works with children under five years old from low-income communities to promote school readiness. The organization in Northwest Indiana provided anecdotal data on delayed social and emotional development of children during the pandemic. Studies have shown that adverse childhood development can have a severe psychological and physiological impact on health outcomes into adulthood. However, there has been a lack of research on quantifying the extent of damage from the pandemic on our Head Start children, who mainly identify as Black/African American.&#x0D; Methods:Geminus Head Start provided demographic data including race, postal codes and DECA for over 4650 students from 2019-2023. DECA, Devereux Early Childhood Assessment, is used by educators to evaluate children’s social emotional competence for early intervention. In this study, we are investigating the DECA categories, including initiative, self-control, and attachment/relationships. We analyzed DECA scores via ANOVA along with listening into the teacher focus groups.&#x0D; Results:Students had increased attachment/relationship scores from the 2019-2020 school year to the 2020-2021 school year (36.69 to 44.59). However, following COVID-19 to the 2021-2022 and 2022-2023 school years, these scores dropped to 23.51. When looking at the second protective factor, self-regulation, the opposite trend was found. The scores went from 18.79 in 2019-2020 down to 14.68 in 2020-2021 and eventually up to 23.51 in 2021-2022.&#x0D; Conclusion:Like most institutions, the pandemic has created a time of isolation and instability for our children and their families. In particular, these children have not been able to access adequate conditions to develop emotional and social maturity. Lacking this development can lead to several negative health outcomes as it may impact mental health and the ability to create healthy supportive networks.

Retrospective Analysis of COVID-19 Impact on Social + Emotional Development in Children of Low-Income Communities from Head Start

Background:Geminus Head Start is a federal program that works with children under five years old from low-income communities to promote school readiness. The organization in Northwest Indiana provided anecdotal data on delayed social and emotional development of children during the pandemic. Studies have shown that adverse childhood development can have a severe psychological and physiological impact on health outcomes into adulthood. However, there has been a lack of research on quantifying the extent of damage from the pandemic on our Head Start children, who mainly identify as Black/African American.&#x0D; Methods:Geminus Head Start provided demographic data including race, postal codes and DECA for over 4650 students from 2019-2023. DECA, Devereux Early Childhood Assessment, is used by educators to evaluate children’s social emotional competence for early intervention. In this study, we are investigating the DECA categories, including initiative, self control, and attachment/relationships. We analyzed DECA scores via ANOVA along with listening into the teacher focus groups.&#x0D; Results:Students had increased attachment/relationship scores from the 2019-2020 school year to the 2020-2021 school year (36.69 to 44.59). However, following COVID-19 to the 2021-2022 and 2022-2023 school years, these scores dropped to 23.51. When looking at the second protective factor, self regulation, the opposite trend was found. The scores went from 18.79 in 2019-2020 down to 14.68 in 2020-2021 and eventually up to 23.51 in 2021-2022.&#x0D; Conclusion:Like most institutions, the pandemic has created a time of isolation and instability for our children and their families. In particular, these children have not been able to access adequate conditions to develop emotional and social maturity. Lacking this development can lead to several negative health outcomes as it may impact mental health and the ability to create healthy supportive networks.

Effect of cognitive behavior therapy training and psychological nursing on the midwifery process in the delivery room.

The severe physical and psychological impact of pain on the physical and mental health of women during labor leads to increased risks and complications during childbirth, presenting a major public health concern. Some studies have shown that cognitive behavioral therapy (CBT) has a positive effect on maternal psychology during delivery, reducing stress and shortening labor time. Thus, CBT training for mothers and delivery room staff may be beneficial in minimizing complications and adverse effects during natural birth. To investigate the clinical effects of CBT training and psychological care during delivery, and their therapeutic effects on women in labor. This study used a retrospective analysis and included 140 mothers admitted to the maternity ward between January 2021 and January 2023. The study subjects were randomized into two groups: control (n = 70) and observation (n = 70). Routine care, CBT training, and psychological care were provided to mothers in both groups. Psychological status scores, delivery time, and satisfaction with care pre- and post-delivery were compared, and the incidence of complications after receiving care was analyzed between the two groups. Although the psychological state of both groups improved significantly in the late stages of labor, the psychological state scores of the mothers in the observation group were significantly lower than those of the mothers in the control group (P < 0.05). The duration of labor and incidence of complications in the observation group were significantly lower than those in the control group (P < 0.05). The mothers in the observation group were significantly more satisfied with nursing care during the course of labor than those in the control group (P < 0.05). CBT training and psychological care for mothers in the midwifery process can effectively improve anxiety and depression, shorten labor duration, reduce postnatal complications, and improve nursing satisfaction and nurse-patient relationships. Its clinical application is effective and has popularization value, providing a new way to protect maternal mental health.

The prevalence and risk factors of PTSD symptoms among nurses during the COVID-19 pandemic-A systematic review and meta-analysis.

Since the first reported outbreak in China, the Coronavirus disease 2019 (COVID-19) has raised serious concerns globally. The COVID-19 pandemic has caused a severe psychological impact on healthcare workers (HCWs), and especially nurses, who are the most numerous and exposed frontline group. This systematic review and meta-analysis aims to summarise extant literature on the effects of the COVID-19 pandemic on the psychological health of nurses, particularly concerning the prevalence and risk factors for post-traumatic stress disorder (PTSD). A systematic search was conducted on PubMed, Embase and PsycInfo from March 2020 to July 2023. Articles were included/excluded on predetermined eligibility criteria. A random-effect meta-analysis was performed using proportions to determine the pooled prevalence for PTSD among nurses. Subgroup analyses were also performed, and heterogeneity across studies was analysed using meta-regression. Relatively high prevalence rates of PTSD were reported among nurse populations during the COVID-19 pandemic in twenty-six different countries, globally. Risk factors associated with PTSD include having prior mental health co-morbidities, being a female, having high exposure/contact with COVID-19 patients, having insufficient protective conditions and having intensive workloads. The overall pooled prevalence was 29.1% (95% C.I. = 23.5%, 35.5%) using a random-effects model in 55 studies. The regression test of funnel plot asymmetry indicated a significant level of publication bias among studies. The COVID-19 pandemic is associated with significant levels of PTSD among frontline nurses globally. A high level of heterogeneity was observed across studies. Psychological, social and administrative interventions should be implemented to mitigate heavy psychological distress in nurses.

An Overview of Mental Health on Stress Among Students in USM

Mental health of higher education students is deteriorating at an alarming rate. The Covid-19 pandemic has had a severe psychological impact on students, who are constantly burdened with various learning tasks as well as online lectures. This study explains the influencing factors that affect the mental health of students in Universiti Sains Malaysia (USM). We conducted an online survey via Google Forms. A total of 150 USM students participated in the online survey. The data gained was interpreted using IBM SPSS Statistic Software to produce meaningful results. The potential causes of stress among USM students that will be discussed briefly in this research are health issues, academic problems, financial difficulties, and family problems. We also consider the Covid-19-pandemic effects on the factors elaborated in this research. Stress can be treated and must be well managed so that it will not become worse. There are many ways and activities that can be done to avoid being stressed.

Psychological Impact of COVID Pandemic among the Armed Forces Healthcare Workers

Introduction: The 2019 novel corona virus (COVID-19) pandemic is an international public health emergency unprecedented in modern history. Hospitals had to rapidly reconfigure clinical spaces and restructure clinical teams to address the surge of patients with COVID-19. The unique situation might have psychological impact such as stress, anxiety, depressive symptoms, insomnia, denial and fear among the military health care workers. Objective: To assess the psychological impact of COVID-19 on army healthcare workers at the designated COVID Hospital in Sylhet cantonment. Methods: A total of 160 participants were selected using convenience sampling from 01 May 2020 to 31 August 2020. The psychological impact was assessed by Impact of Event Scale-Revised (IES-R) adopted from Horowitz 1979. The 22-item scale comprised of 3 subscales representative of the major symptom clusters of post-traumatic stress: intrusion, avoidance and hyper-arousal. Stress for job, financial issue, home and feeling horrified or helpless due to the COVID-19 were also assessed. Results: Majority (46.3%) of the participants were revealed with mild psychological impact. Moderate and severe impact was found among 18.8% and 7.5% respondents respectively. Mean stress (0-88) was observed as 27.79±6.94. Mean intrusion (27.21±10.924) and Hyper-arousal (19.57±8.130) depicted mild to moderate but Avoidance (34.53±11.072) revealed relatively high level of stress. Majority were not at all stressed for financial issue (49.4%) or for their job (46.3%). But stress for family (20%), feeling horrified (31.9%) and helpless (31.9%) was moderate. Conclusion: The study observed mild to moderate psychological impact among the respondents. A considerable proportion was found to have severe psychological impact which demands appropriate intervention. JAFMC Bangladesh. Vol 18, No 2 (December) 2022: 35-39

Impact of COVID-19 Pandemic on the Medical Oncology Department of a Tertiary Care Hospital

Objective: To assess the degree of impact the pandemic had on the Oncology Department regarding patient visits and elective procedures.&#x0D; Study Design: Comparative pre-post analysis study.&#x0D; Place and Duration of Study: Medical Oncology Department of Combined Military Hospital, Lahore Pakistan, from Oct to Dec 2019 before the pandemic, and then 2020 during the pandemic.&#x0D; Methodology: Data was collected from the Department regarding the number of outpatient visits, indoor admissions, new cases diagnosed, chemotherapies administered, blood transfusions, and various procedures like lumbar puncture, ascitic fluid paracentesis, pleural fluid drainage, etc.&#x0D; Results: Our study showed an overall decrease in all the study parameters. The average monthly Outpatient visits fell by 395 patients (55.6%). The new cases decreased by 25 patients (36.2%). The indoor admissions also came down by 17 patients (42.5%). Furthermore, the procedures performed in the Oncology department were also observed to have decreased.&#x0D; Conclusion: Oncology has suffered dramatically in the face of the COVID-19 pandemic, with fewer patients visiting the hospital for their consultations, follow-ups, as well as treatments. This has resulted in a delay in diagnosis and treatment and has had a severe adverse psychological impact on the patients.Keywords: COVID-19, Elective procedures, Pandemic, Oncology.

Short-Term Psychological Impact of the 2019 Coronavirus Disease (COVID-19) Pandemic on Healthcare Workers of a Cancer Treatment Center: A Cross-Sectional Study

Background: The sudden emergence of the novel and severe 2019 Coronavirus disease (COVID-19) would be expected to impact the mental health of healthcare workers and thus represent a challenge to psychological resilience. In order to reduce psychological impacts, more research data are needed to help develop evidence-based strategies. We conducted a single center, cross-sectional study, with the aim of assessing the immediate psychological impact of COVID-19 pandemic on medical and paramedical staff in a cancer treatment center providing continuous health care during the pandemic. Methods: From April 19th to May 5th, 2020, medical and nursing staff from Oncology and Hematology Center of Mohammed VI University Teaching Hospital was invited to participate with a self-report questionnaire. We used Impact of Event Scale-Revised (IES-R), Hospital Anxiety and Depression scale (HADS), and Insomnia Severity Index (ISI) to evaluate stress, anxiety, depression, and insomnia, respectively. Additional information on demographic characteristics, medical history, exposure to COVID-19, and accessed mental health services were included in the questionnaire. Results: We received 93 completed questionnaires. Among all healthcare workers included in this study, 30.1% reported stress, 32.3% had anxiety, 30.1% reported depression, and 31.2% had insomnia symptoms. Occupation, female gender, concomitant chronic diseases, history of mental disorders, and history of contact with suspected or confirmed patients were risk factors for psychological disturbances, whereas care provided by hospital decision-makers, and full coverage of all departments with protective measures were protective factors. Conclusion: During the initial phase of COVID-19 outbreak in Morocco, about one-third of the respondents reported moderate to severe psychological impact, and more than half rated their anxiety, depression symptoms, and insomnia as moderate to severe. Our findings emphasize the importance ...........

The psychological impact of the COVID-19 outbreak among the fever patients in the lockdown zone

BackgroundCOVID-19 pandemic is still ongoing, which not only impact physical health but psychological health. This research aims to analyze the psychological impact of residents with a fever (> 37 °C) during the COVID-19 outbreak in one community.MethodsThere were 105 participants surveyed online from 7th March to 21st March 2022. Collected the data included the socio-demographics, health status, COVID-19 knowledge and concerns and the Impact of Events Scale-Revised (IES-R) ratings.ResultsAmong those participants, the IES-R mean score was 24.11 (SD = 6.12), and 30.48% of respondents reported a moderate to the severe psychological impact. Female gender; youth age; single status; other specific symptoms; concerns about family members, and discrimination were significantly associated with the greater psychological impact of the COVID-19 event (p < 0.05).ConclusionsIn the lockdown zone, about one-third of the residents have an obvious psychological impact after fever. The factors identified can be used to make effective psychological support strategies in the early stages of the COVID-19 outbreak.

Immediate Psychological Responses &amp; Associated Demographic Factors during the Lockdown Period of the COVID- 19 Outbreak among the Bangladeshi University Students

The massive spread of COVID-19 has put people’s standard of living in jeopardy.&#x0D; The mental health status of the students has been a matter of concern throughout the&#x0D; lockdown. The study aims to identify university students’ immediate psychological&#x0D; responses as an index of mental health outcomes during the COVID-19 outbreak&#x0D; lockdown period and to investigate demographic predictors of their mental health&#x0D; outcomes. 167 students responded to a web-based cross-sectional survey that included&#x0D; the IES-R and DASS-21BV in addition to demographic data and relevant COVID-19&#x0D; questions. 49.2% of the respondents reported stress, 54.6% reported anxiety, 64.2%&#x0D; reported depression ranging from mild to extremely severe, based on DASS-21, and&#x0D; 68.9% of respondents rated having a mild to severe psychological impact from the&#x0D; lockdown on the IES-R. Age was significantly associated with the DASS stress subscale&#x0D; (B = -.159, AR2 =.019, 95% CI: -1.023 to -.021). The study ascertains the commonness&#x0D; of the psychological impact of the lockdown period of the COVID-19 outbreak on&#x0D; university students, necessitating immediate intervention to cope with the unprecedented&#x0D; situation and minimize future mental health problems.

Accelerated Repigmentation of Halo Nevus Following Excision: A Case Report

BACKGROUND: Halo nevus is a benign condition characterized by symmetrical oval-shaped and well-defined hypopigmented patch surrounding melanocytic lesions. Their sizes varies from a few millimeters to centimeters. A “wait and see” approach is usually preferred in most cases of halo nevus. However, the condition can cause severe psychological impact and impair patient’s quality of life, especially when it emerges on prominent areas such as the face. Surgical option can be utilized for removal of melanocytic lesions and accelerate regression of the halo. CASE PRESENTATION: We report a case of a 25-year-old woman with white patches around two moles on her face who was diagnosed as halo nevus. Surgical excision was performed and a 12-week follow-up showed reduction in diameter of the halo nevus. CONCLUSION: Large halo nevus can cause significant esthetic burden that may affect patient’s quality of life. A more invasive approach such as excision of underlying nevus may be used to achieve more rapid results.

Guidelines for the Management of Patients with Alopecia Areata in Korea: Part I Topical and Device-based Treatment.

Alopecia areata (AA) is a chronic disease with an unpredictable disease course and severe psychological impact. To provide evidence- and consensus-based insights regarding the treatment of patients with AA in Korea. We searched for relevant studies on the topical and device-based treatment of AA in the literature from inception until May 2021. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statements, and an agreement of 75% or greater was considered as consensus. Currently, there remains a scarcity of topical treatments, which is supported by robust evidence from a number of high-quality randomized controlled trials. Current evidence supports the efficacy of topical corticosteroids, corticosteroid intralesional injection, and contact immunotherapy in AA patients. Topical corticosteroids and contact immunotherapy are recommended for pediatric AA. A consensus was achieved in 6 out of 14 (42.8%), and 1 out of 5 (20.0%) statements pertaining to topical and device-based treatments in AA, respectively. The expert consensus was from a single country, and the study may not cover all the treatments used. The present study provides up-to-date, evidence-based treatment guidelines for AA based on the consensus reached among experts after considering regional healthcare circumstances, adding diversity to the previous guidelines.

Guidelines for the Management of Patients with Alopecia Areata in Korea: Part II Systemic Treatment.

Alopecia areata (AA) is a chronic disease with an unpredictable course and can have a severe psychological impact on an individual. To provide evidence and consensus-based statements regarding the treatment of patients with AA in Korea. We searched for relevant studies from inception to May 2021 regarding the systemic treatment of AA. Evidence-based recommendations were also prepared. The evidence for each statement was graded and classified according to the strength of the recommendations. Hair experts from the Korean Hair Research Society (KHRS) voted on the statement, and an agreement of 75% or greater was considered as having reached consensus. Current evidence supports the efficacy of systemic corticosteroids, oral cyclosporine monotherapy or combination with systemic corticosteroids, and oral Janus kinase inhibitors in severe AA patients. Systemic steroids may be considered for pediatric patients with severe AA. A consensus was achieved in three out of nine (33.3%), and one out of three (33.3%) statements pertaining to systemic treatment in adult and pediatric AA, respectively. The present study produced up-to-date, evidence-based treatment guidelines for AA associated with the consensus obtained by experts based on the Korean healthcare system.