FEATURES OF SENSITIZATION IN PATIENTS WITH ALOPECIA AREATA, ASSOCIATED WITH ATOPIC DISEASES

Abstract

BACKGROUND: Association of alopecia areata (AA) and atopic diseases (AD) has been confirmed in clinical, epidemiologic, genetic and immunologic studies. The study of sensitization and AD structure in AA-patients makes it possible to develop atopy screening and suggest additional treatment options for AA. AIMS: To determine the sensitization spectrum and AD structure in patients with AA considering the age and clinical form of alopecia. MATERIALS AND METHODS: A comparative uncontrolled study was conducted. The data of 162 patients 5 - 51 years with AA, atopic dermatitis, asthma, allergic rhinitis/rhinoconjuctivitis for the period from April 2022 to May 2023 were used. The nature of sensitization and the structure of AD were analyzed. Clinical forms of AA were assessed by the hair-loss area. RESULTS: The patients were divided according to AA-status: the first group included 54 AA-patients with AD, the second (comparison group) - 108 atopic patients without AA. Subgroups were formed according to age: in group 1 - 31 (57%) were children (5 - 17 y.o.), 23 (43%) - adults 18 years and older; in group 2 – 58 (54%) and 50 (46%) children and adults, respectively. Among AA-patients seasonal pollen sensitization prevailed (22/54 people); polyvalent sensitization was observed in 13/54 people, 6 of whom had severe forms of AA, 6 - ophiasis. Comparison of the sensitization spectrum between the groups revealed no differences. In group of adult AA-patients isolated respiratory allergies were significantly less frequent (OR 0.21; CI [0.07- 0.60], p=0.004), but combined AD were more frequently observed (OR 4.71; CI [1.43-15.58], p=0.012). Most patients with severe AA were children (8/12) with polyvalent sensitization and respiratory and combined AD. CONCLUSIONS: The comorbidity of AA and atopy is manifested by an increased incidence of severe alopecia in childhood and a tendency to progression of allergic inflammation, realized in the form of combined AD. The spectrum of sensitization in patients with and without AA does not differ and characterized by the predominance of the most common allergens (plant pollen). These results indicate the need for timely atopy detection and desensitization therapy in AA-patients, especially with early onset and active disease.