Small study defines alopecia areata patterns in children: clobetasol appears effective.

SEATTLE -- Results from the first study of alopecia areata in North American children suggest that high-potency clobetasol propionate is effective and does not appear to have long-term adverse clinical effects in this patient population, Dr. Patsy Lenane reported in a poster session at the annual meeting of the Pediatric Academic Societies.

For the study, Dr. Lenane and her associates collected medical information on 79 children with alopecia areata who attended the pediatric dermatology clinic at the Hospital for Sick Children, Toronto, from January through December 2001.

Medical charts were used to collect information on age, gender, medical history, family medical history, presenting pattern, treatment in the clinic, and treatment side effects.

The average age of the children was 8 years, and 47 (59%) were female. Four cases (5%) were congenital and 41 (52%) occurred before the age of 6, said Dr. Lenane of the hospital's department of dermatology. Nail changes and atopy were each noted in 12 children (15%).

The findings of female preponderance, young age at disease onset, the frequency of congenital alopecia areata, and the low incidence of autoimmune disease in the children and their families have not been previously reported, Dr. Lenane said.

Initial treatment in the clinic was as follows: 47 patients (59%) began treatment with the high-potency class I topical steroid clobetasol; 15 (19%) started on a class II topical steroid; 8 (10%) began with a class III topical steroid; 8 (10%) did not receive any treatment. One child started on topical tacrolimus.

Of children treated with clobetasol, improvement at 3 months was seen in 18 of 22 (80%) with moderate alopecia areata, 2 of 3 (66%) with severe patchy alopecia areata, and 6 of 10 (60%) with alopecia totalis.

Skin atrophy was seen in six children with continuous use of dobetasol, which resolved with intermittent therapy, Dr. Lenane said at the meeting, which was sponsored by the American Pediatric Society, the Society for Pediatric Research, and the Ambulatory Pediatric Association.

DOUG BRUNK

San Diego Bureau