학술논문
The Alopecia Areata Severity and Morbidity Index (ASAMI) Study: Results From a Global Expert Consensus Exercise on Determinants of Alopecia Areata Severity.
Document Type
Academic Journal
Author
Moussa A; Sinclair Dermatology, East Melbourne, Victoria, Australia.; Bennett M; Sinclair Dermatology, East Melbourne, Victoria, Australia.; Wall D; Hair Restoration Blackrock, Dublin, Ireland.; National and International Skin Registry Solutions (NISR), Charles Institute of Dermatology, University College Dublin, Dublin, Ireland.; Meah N; St Helens & Knowsley National Health Service Trust, St Helens, United Kingdom.; Manchester University, Faculty of Biology, Medicine and Health, Manchester, United Kingdom.; York K; Netcare Greenacres Hospital, Port Elizabeth, South Africa.; Bokhari L; Sinclair Dermatology, East Melbourne, Victoria, Australia.; Asfour L; Salford Royal Foundation Trust, Northern Care Alliance, Manchester, United Kingdom.; Rees H; Sinclair Dermatology, East Melbourne, Victoria, Australia.; Abraham LS; Trichology Unit of Hospital Regional da Asa Norte, Brasilia-DF, Brazil.; Asz-Sigall D; Trichology Clinic, Dermatology Department, Dr Manuel Gea Gonzalez General Hospital, Mexico City, Mexico.; Basmanav FB; Institute of Human Genetics, University Hospital of Bonn & University of Bonn, Bonn, Germany.; Bergfeld W; Cleveland Clinic Foundation, Cleveland, Ohio.; Betz RC; Institute of Human Genetics, University Hospital of Bonn & University of Bonn, Bonn, Germany.; Bhoyrul B; Sinclair Dermatology, East Melbourne, Victoria, Australia.; Blume-Peytavi U; Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany.; Callender V; Callender Dermatology and Cosmetic Center, Glenn Dale, Maryland.; Chitreddy V; Sinclair Dermatology, East Melbourne, Victoria, Australia.; Combalia A; Dermatology Department, Hospital Clinic de Barcelona, Barcelona, Spain.; Cotsarelis G; Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia.; Craiglow B; Department of Dermatology, Yale School of Medicine, New Haven, Connecticut.; Dhurat R; LTMMC and LTMG Hospital Sion Mumbai, Mumbai, India.; Donovan J; Donovan Hair Clinic, University of British Columbia, Whistler, British Columbia, Canada.; Doroshkevich A; Center of Hair Treatment and Transplantation, St Petersburg, Russia.; Eisman S; Sinclair Dermatology, East Melbourne, Victoria, Australia.; Australasian Hair and Wool Research Society, Melbourne, Victoria, Australia.; Farrant P; Brighton and Sussex University Hospitals National Health Service Trust, Brighton, United Kingdom.; Ferrando J; Dermatology Department, Hospital Clinic de Barcelona, Barcelona, Spain.; Gadzhigoroeva A; Moscow Scientific & Practical Center of Dermatology, Venereology and Cosmetology, Russian Federation.; Green J; Department of Dermatology, Saint Vincent's Hospital, Victoria, Australia.; Grimalt R; Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain.; Harries M; Salford Royal Hospital, Northern Care Alliance National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom.; Centre for Dermatology Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.; Hordinsky M; Department of Dermatology, University of Minnesota, Minneapolis.; Irvine A; Clinical Medicine, Trinity College Dublin, Dublin, Ireland.; Jolliffe V; Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.; Kaiumov S; Clinic of Trichology and Cosmetology Nautilus, Saint-Petersburg, Russia.; King B; Yale School of Medicine, New Haven, Connecticut.; Lee J; National Skin Centre, Singapore.; Lee WS; Department of Dermatology, Yonsei University, Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon-do, Republic of Korea.; Li J; Department of Dermatology, Saint Vincent's Hospital, Victoria, Australia.; University of Melbourne, Melbourne, Victoria, Australia.; Department of Dermatology, Eastern Health, Melbourne, Victoria, Australia.; Skin Health Institute, Carlton, Melbourne, Victoria, Australia.; Lortkipanidze N; David Tvildiani Medical University, Tbilisi, Georgia.; McMichael A; Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.; Mesinkovska NA; Department of Dermatology, School of Medicine, University of California, Irvine.; Messenger A; Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.; Mirmirani P; The Permanente Medical Group, Vallejo, California.; Olsen E; Duke Dermatology Clinic, Durham, North Carolina.; Orlow SJ; Grossman School of Medicine, New York University, New York, New York.; Ovcharenko Y; Department of Infectious Diseases and Clinical Immunology, V. N. Karazin Kharkiv National University, Kharkiv, Ukraine.; Piraccini BM; Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Department of Medical and Surgical Sciences University of Bologna, Bologna, Italy.; Pirmez R; Instituto de Dermatologia Professor Rubem David Azulay-Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil.; Rakowska A; Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.; Reygagne P; Centre de Santé Sabouraud, Hopital Saint Louis, Vellefaux, Paris, France.; Rudnicka L; Department of Dermatology, Medical University of Warsaw, Warsaw, Poland.; Corralo DS; Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy.; Senna M; Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts.; Harvard Medical School, Harvard University, Boston, Massachusetts.; Shapiro J; Disorders of the Hair and Scalp, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.; Sharma P; Sinclair Dermatology, East Melbourne, Victoria, Australia.; Siliuk T; Hair Treatment and Transplantation Center, Saint Petersburg, Russian Federation.; Starace M; Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.; Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.; Suchonwanit P; Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.; Takwale A; Editorial Advisory Board, Indian Journal of Dermatology Venereology Leprosy.; Tosti A; Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida.; Vañó-Galván S; Dermatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Universidad de Alcalá, Madrid, Spain.; Trichology Unit, #TricoHRC Research Group, Madrid, Spain.; Visser WI; Division of Dermatology, Stellenbosch University, Cape Town, South Africa.; Vogt A; Department of Dermatology, Venerology and Allergology, Clinical Research Center for Hair and Skin Science, Charité-Universitaetsmedizin Berlin, Berlin, Germany.; Wade M; The London Skin and Hair Clinic, London, United Kingdom.; Yip L; Skin Partners Specialist Dermatologists, Brisbane, Australia.; Zhou C; Department of Dermatology, Peking University People's Hospital, Xicheng District, Beijing, China.; Sinclair R; Sinclair Dermatology, East Melbourne, Victoria, Australia.; Australasian Hair and Wool Research Society, Melbourne, Victoria, Australia.; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
Source
Publisher: American Medical Association Country of Publication: United States NLM ID: 101589530 Publication Model: Print Cited Medium: Internet ISSN: 2168-6084 (Electronic) Linking ISSN: 21686068 NLM ISO Abbreviation: JAMA Dermatol Subsets: MEDLINE
Subject
Language
English
Abstract
Importance: Current measures of alopecia areata (AA) severity, such as the Severity of Alopecia Tool score, do not adequately capture overall disease impact.
Objective: To explore factors associated with AA severity beyond scalp hair loss, and to support the development of the Alopecia Areata Severity and Morbidity Index (ASAMI).
Evidence Review: A total of 74 hair and scalp disorder specialists from multiple continents were invited to participate in an eDelphi project consisting of 3 survey rounds. The first 2 sessions took place via a text-based web application following the Delphi study design. The final round took place virtually among participants via video conferencing software on April 30, 2022.
Findings: Of all invited experts, 64 completed the first survey round (global representation: Africa [4.7%], Asia [9.4%], Australia [14.1%], Europe [43.8%], North America [23.4%], and South America [4.7%]; health care setting: public [20.3%], private [28.1%], and both [51.6%]). A total of 58 specialists completed the second round, and 42 participated in the final video conference meeting. Overall, consensus was achieved in 96 of 107 questions. Several factors, independent of the Severity of Alopecia Tool score, were identified as potentially worsening AA severity outcomes. These factors included a disease duration of 12 months or more, 3 or more relapses, inadequate response to topical or systemic treatments, rapid disease progression, difficulty in cosmetically concealing hair loss, facial hair involvement (eyebrows, eyelashes, and/or beard), nail involvement, impaired quality of life, and a history of anxiety, depression, or suicidal ideation due to or exacerbated by AA. Consensus was reached that the Alopecia Areata Investigator Global Assessment scale adequately classified the severity of scalp hair loss.
Conclusions and Relevance: This eDelphi survey study, with consensus among global experts, identified various determinants of AA severity, encompassing not only scalp hair loss but also other outcomes. These findings are expected to facilitate the development of a multicomponent severity tool that endeavors to competently measure disease impact. The findings are also anticipated to aid in identifying candidates for current and emerging systemic treatments. Future research must incorporate the perspectives of patients and the public to assign weight to the domains recognized in this project as associated with AA severity.
Objective: To explore factors associated with AA severity beyond scalp hair loss, and to support the development of the Alopecia Areata Severity and Morbidity Index (ASAMI).
Evidence Review: A total of 74 hair and scalp disorder specialists from multiple continents were invited to participate in an eDelphi project consisting of 3 survey rounds. The first 2 sessions took place via a text-based web application following the Delphi study design. The final round took place virtually among participants via video conferencing software on April 30, 2022.
Findings: Of all invited experts, 64 completed the first survey round (global representation: Africa [4.7%], Asia [9.4%], Australia [14.1%], Europe [43.8%], North America [23.4%], and South America [4.7%]; health care setting: public [20.3%], private [28.1%], and both [51.6%]). A total of 58 specialists completed the second round, and 42 participated in the final video conference meeting. Overall, consensus was achieved in 96 of 107 questions. Several factors, independent of the Severity of Alopecia Tool score, were identified as potentially worsening AA severity outcomes. These factors included a disease duration of 12 months or more, 3 or more relapses, inadequate response to topical or systemic treatments, rapid disease progression, difficulty in cosmetically concealing hair loss, facial hair involvement (eyebrows, eyelashes, and/or beard), nail involvement, impaired quality of life, and a history of anxiety, depression, or suicidal ideation due to or exacerbated by AA. Consensus was reached that the Alopecia Areata Investigator Global Assessment scale adequately classified the severity of scalp hair loss.
Conclusions and Relevance: This eDelphi survey study, with consensus among global experts, identified various determinants of AA severity, encompassing not only scalp hair loss but also other outcomes. These findings are expected to facilitate the development of a multicomponent severity tool that endeavors to competently measure disease impact. The findings are also anticipated to aid in identifying candidates for current and emerging systemic treatments. Future research must incorporate the perspectives of patients and the public to assign weight to the domains recognized in this project as associated with AA severity.