Epidemiology and Comorbidity of Patients with Alopecia Areata in Germany - Analysis of Longitudinal Claims Data

Br J Dermatol. 2023 Oct 19:ljad381. doi: 10.1093/bjd/ljad381. Online ahead of print.

ABSTRACT

BACKGROUND: Alopecia areata (AA) is a chronic, immune-mediated disease characterised by acute onset hair loss. The hair loss can range from small, circumscribed hairless areas on the scalp to complete loss of head and body hair. However, data on the epidemiology of AA are limited. Current evaluations are lacking in Germany. The aim of this study was to evaluate the epidemiology and comorbidity of AA in Germany based on claims data.

METHODS: A representative 40% sample of all adults who were insured with a German statutory health insurance (DAK-G) between 2016 and 2020 was evaluated (n = 2.88 million). Based on at least one relevant outpatient or inpatient diagnosis of ICD-10 L63, the annual AA prevalence and incidence (ICD-10 L63) were calculated for 2016 to 2020. Different case definitions were used for diagnosis validation. In addition, the occurrence of comorbidities in AA patients was investigated.

RESULTS: In 2020, AA prevalence was 210 per 100,000 and incidence 72 per 100,000. Compared to persons without AA, those with AA significantly more often had atopic dermatitis (rate ratio (RR) 2.9), pruritus (RR 2.7), lupus erythematosus (RR 2.4), urticaria (RR 2.3) and psoriasis (RR 2.2). Women were affected slightly more often than men (0.2% vs. 0.1%). On a regional level, higher prevalence and incidence rates were found in Brandenburg (prevalence: 332; incidence: 116 per 100,000), Hesse (344 and 124 per 100,000, respectively) and Mecklenburg-Western Pomerania (303 and 111 per 100,000, respectively).

CONCLUSION: AA is a common immune-mediated skin condition with a relevant prevalence and marked regional variations in Germany. For a complete understanding of epidemiology, complementary population-based exams including clinical characteristics of AA are useful.

PMID:37852247 | DOI:10.1093/bjd/ljad381