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Incidence of Alopecia Areata in Olmsted County, Minnesota, 1975 Through 1989


      To assess the incidence and natural history of alopecia areata (AA) among unselected patients from a community.


      We conducted a retrospective population-based descriptive study of AA among residents of Olmsted County, Minnesota, for the period from 1975 through 1989.

      Material and Methods

      After identifying 292 Olmsted County residents first diagnosed with AA during the 15-year study period, we reviewed their complete (inpatient and outpatient) medical records in the community and statistically analyzed the effects of gender and age-group.


      The overall incidence of AA was 20.2 per 100,000 person-years and did not change with time. Rates were similar in the two genders and over all ages, and lifetime risk was estimated at 1.7%. Eighty-seven percent of patients were examined by a dermatologist who diagnosed AA, and 29% of cases were confirmed by biopsy. Most patients had mild or moderate disease, but alopecia totalis or universalis developed at some point during the clinical course in 21 patients.


      This study of the incidence and natural history of AA in a community shows that this disorder is fairly common and can be seen at all ages. Although spontaneous resolution is expected in most patients, a small but significant proportion of cases (probably approximately 7%) may evolve into severe and chronic hair loss, which may be psychosocially devastating for affected persons.
      AA (alopecia areata), CI (confidence interval)
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        • Bertolino AP
        • Freedberg IM
        in: Fitzpatrick TB Eisen AZ Wolff K Frecdberg IM Austen KF 4th ed. Dermatology in General Medicine. Vol 1. McGraw-Hill, New York1993: 671-696
        • Brown WH
        Aetiology of alopecia areata and its relationship to vitiligo and possibly sclerodermia.
        Br J Dermatol. 1929; 41: 299-323
        • Anderson I
        Alopecia areata: a clinical study.
        BMJ. 1950; 2: 1250-1252
        • Walker SA
        • Rothman S
        Alopecia areata: a statistical study and consideration of endocrine influences.
        J Invest Dermatol. 1950; 14: 403-413
        • Arnold Jr, HL
        Alopecia areata: prevalence in Japanese and prognosis after reassurance.
        Arch Dermatol Syph. 1952; 66: 191-196
        • Muller SA
        • Winkelmann RK
        Alopecia areata: an evaluation of 736 patients.
        Arch Dermatol. 1963; 88: 290-297
        • Gip L
        • Lodin A
        • Molin L
        Alopecia areata: a follow-up investigation of outpatient material.
        Acta Derm Venereol. 1969; 49: 180-188
        • Gollnick H
        • Orfanos CE
        Alopecia areata: pathogenesis and clinical picture.
        in: Orfanos CE Happle R Hair and Hair Diseases. Springer-Verlag, New York1990: 529-569
        • Muller SA
        Alopecia: syndromes of genetic significance.
        J Invest Dermatol. 1973; 60: 475-492
        • Kurland LT
        • Molgaard CA
        The patient record in epidemiology.
        Sci Am. 1981 Oct; 245: 54-63
      1. Bergstralh EJ, Offord KP, Chu C-P, Beard CM, O'Fallon WM, Melton LJ HI. Calculating incidence, prevalence and mortality rales for Olmsled County, Minnesota residents: an update. Technical Report Scries, No. 49, Section of Biosta-tistics. Mayo Clinic, Rochester, Minnesota, March 1992

      2. Beyer WH CRC Handbook of Tables for Probability and Statistics. Chemical Rubber Company, Cleveland1966: 58-64
        • Kaplan EL
        • Meier P
        Nonparamclric estimation from incomplete observations.
        J Am Stat Assoc. 1958; 53: 457-481
        • Peto R
        • Peto J
        Asymptotically efficient rank invariant test procedures [with discussion].
        J R Stat Soc [A]. 1972; 135: 185-207
        • McCullagh P
        • Nelder JA
        Generalized Linear Models. Chapman and Hall, London1983
        • Roger JH
        A significance test for cyclic trends in incidence data.
        Biometrika. 1977; 64: 152-155
        • Safavi K
        Prevalence of alopecia areata in me First National Health and Nutrition Examination Survey [letter].
        Arch Dermatol. 1992; 128: 702
        • Arnold Jr, HL
        • Odom RB
        • James WD
        Diseases of the Skin: Clinical Dermatology. 8th ed. Saunders, Philadelphia1990: 879-882
        • Melton LJ III
        The impact of referral bias on primary care.
        Continuing Educ. 1981 Jul; 15 (75): 78-80
        • Hordinsky MK
        in: Sams Jr, WJ Lynch PJ Principles and Practice of Dermatology. Churchill Livingstone, New York1990: 761-780
        • Shellow WV
        • Edwards JE
        • Koo JY
        Profile of alopecia areata: a questionnaire analysis of patient and family.
        Int J Dermatol. 1992; 31: 186-189
        • Werth VP
        • White WL
        • Sanchez MR
        • Franks AG
        Incidence of alopecia areata in lupus erythematosus.
        Arch Dermatol. 1992; 128: 368-371
        • Friedmann PS
        Clinical and immunologic associations of alopecia areata.
        Semin Dermatol. 1985; 4: 9-15
        • Bennett PH
        Epidemiology of diabetes mellilus.
        in: Rifkin H Porte Jr, D Diabetes Mellitus: Theory and Practice. 4th ed. Elsevier, New York1990: 357-377