Disclosures: King reports serving on the advisory board, consulting for and/or being a clinical trial investigator for Aclaris Therapeutics, Almirall, Arena Pharmaceuticals, Bioniz Therapeutics, Bristol Myers Squibb, Concert Pharmaceuticals, Dermavant Sciences, Eli Lilly and Company, Incyte, Pfizer, TWi Biotechnology and Viela Bio, and serving on the speaker bureaus for Pfizer, Regeneron and Sanofi Genzyme. Please see the study for all other authors’ relevant financial disclosures.
September 27, 2021
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Scalp hair loss, psychosocial factors should determine alopecia areata disease severity

Disclosures: King reports serving on the advisory board, consulting for and/or being a clinical trial investigator for Aclaris Therapeutics, Almirall, Arena Pharmaceuticals, Bioniz Therapeutics, Bristol Myers Squibb, Concert Pharmaceuticals, Dermavant Sciences, Eli Lilly and Company, Incyte, Pfizer, TWi Biotechnology and Viela Bio, and serving on the speaker bureaus for Pfizer, Regeneron and Sanofi Genzyme. Please see the study for all other authors’ relevant financial disclosures.
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Scalp hair loss should be a key criterion in assessing disease severity of alopecia areata, according to results of an expert panel survey.

“The current classification for alopecia areata (AA) does not provide a consistent assessment of disease severity,” Brett A. King, MD, PhD, associate professor of dermatology at Yale University, and colleagues wrote.

Scalp hair loss should be a key criterion in assessing disease severity of alopecia areata, according to results of an expert panel survey.

Using a modified Delphi process, the researchers convened an advisory group of 22 U.S.-based board certified dermatologists and clinical experts in AA with the aim of developing a severity scale for the condition. The scale was based on expert experience and included feedback from pharmaceutical industry representatives.

Six experts developed a survey that was sent to the entire panel. The group conducted three surveys. After a final meeting, a consensus vote was taken on a proposed AA severity scale.

Scalp hair loss was determined to be the key factor in determining AA disease severity. In addition, there was broad agreement that depression, anxiety and psychosocial impact related to AA also should be included in the scale.

Other factors that were considered included eyebrow and eyelash involvement and treatment-refractory disease.

The group noted that the scale should be used for clinical practice but not clinical trials.

“The final AA disease severity scale, anchored on extent of hair loss, captures key features commonly used by AA experts in clinical practice,” the researchers wrote. “This scale will better aid clinicians in appropriately assessing severity in patients with this common disease.”