Background: Family history of alopecia areata has been associated with more severe clinical presentations, but its specific prognostic implications in patchy alopecia remains unclear.
Objective: To evaluate the relationship of family history of alopecia areata with demographics, triggers, comorbidities, disease course, and relapse rate in patchy alopecia.
Methods: The medical records of 256 patients seen over a 17-year period was examined. Data collected included demographics, comorbidities, disease severity, and response to treatment. Comparisons were drawn using Pearson chi-square tests, Fisher exact tests, Wilcoxon rank sum tests, and t-tests as appropriate.
Results: Family history of alopecia areata was associated with reduced hair regrowth after relapses, more severe symptoms, and earlier age of onset. Stress/fatigue, illnesses, thyroid disorders, and season changes were the most common relapse triggers. Dermatologic disorders were the most common comorbidities, followed by atopy and autoimmune disease.
Limitations: Given the retrospective nature of data collection, most measures have some missing data, which may impact findings.
Conclusion: Patchy alopecia patients with a family history of alopecia areata experienced worse outcomes. Concomitant autoimmunity may also adversely affect alopecia areata disease course. Identification of a positive family history of alopecia areata and control of autoimmune comorbidities may aid alopecia areata management.