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Thyroid Screening Suggested for Youngsters with AA

JAMA Dermatol; ePub 2017 Sep 27; Patel, et al

In a recent, retrospective, medical chart review of 298 patients with alopecia areata (AA) (aged 0-21 years), researchers discovered that a history of Down syndrome, atopy, and family history of thyroid disease had significant association with incidence of thyroid abnormalities. Patients who received a clinical diagnosis of AA and underwent thyroid function tests were included. They found:

  • Of those with thyroid screening, patterns of AA included patchy (68%), ophiasis (13%), totalis (9%), and universalis (10%).
  • Severity was determined by percentage of hair loss on the scalp and were divided into mild (30.2%), moderate (32.9%), and severe (36.9%).
  • A total of 59 (20%) patients had abnormalities on thyroid testing results.
  • Whereas age, duration of disease, pattern of alopecia, and diagnosis of autoimmune diseases had no significant association with abnormal thyroid findings, a personal history of Down syndrome, atopy, and family history of thyroid disease did.

It is recommended that routine thyroid function screening should be restricted to AA patients with a medical history of Down syndrome, personal history of atopy, a family history of thyroid disease, or clinical findings (goiter) suggestive of potential thyroid dysfunction in the individual patient.


Patel D, Bauer AJ, Castelo-Soccio L. Screening guidelines for thyroid function in children with alopecia areata. [Published online ahead of print September 27, 2017]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.3694.