The Epidemiology of Atopic Dermatitis Among Adults and Adolescents with Alopecia Areata in the United States

Christopher G Bunick; April W Armstrong; Ayman Grada; Ahmed M Soliman; Chao Li; Claire C Bristow; Imran A Khan; Dawid Lipiszko; Jonathan I Silverberg; Naiem T Issa; Arash Mostaghimi

doi:10.1016/j.jid.2025.06.1578

The Epidemiology of Atopic Dermatitis Among Adults and Adolescents with Alopecia Areata in the United States

J Invest Dermatol. 2025 Jun 26:S0022-202X(25)02236-5. doi: 10.1016/j.jid.2025.06.1578. Online ahead of print.

Authors

Affiliations

¹ Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA; Program in Translational Biomedicine, Yale School of Medicine, New Haven, Connecticut, USA.
² Department of Dermatology, University of California Los Angeles, Los Angeles, California, USA.
³ AbbVie Inc., North Chicago, Illinois, USA.
⁴ Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
⁵ Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA; Issa Research and Consulting, LLC, Springfield, Virginia, USA; Forefront Dermatology, Vienna, Virginia, USA; Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
⁶ Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts, USA. Electronic address: amostaghimi@bwh.harvard.edu.

PMID: 40581103
DOI: 10.1016/j.jid.2025.06.1578

Abstract

This study evaluated the prevalence, incidence, and relative risk of comorbid atopic dermatitis (AD) among patients with alopecia areata (AA) using data from the Merative™ MarketScan® Research Databases. Eligible patients had ≥1 inpatient or ≥2 outpatient claims for AA between 01/01/2017 and 10/31/2023, were aged ≥12 years, and were continuously enrolled during the ≥5-year baseline period through the 6-month follow-up period; index date was the earliest date of AA diagnosis. AD prevalence (%) and incidence (cases/1000 person-years) among patients with AA are reported and stratified by disease severity; a subgroup analysis was performed among adolescents (12-17 years). Adjusted hazard ratios for being diagnosed with AD are reported for patients with moderate-to-severe versus mild AA. Prevalence of AD among patients with AA at baseline was 3.2% (overall prevalence in database: 12.1%), with most having moderate-to-severe AD; prevalence was higher among adolescents with AA (7.6%). Incidence of AD increased with AA disease severity, regardless of age. Those with moderate-to-severe AA had 78% higher risk of being diagnosed with AD than those with mild disease. Dermatologist-diagnosed patients had higher rates of comorbid AD regardless of AA severity. These data demonstrate the importance of increased risk of comorbid AD when making treatment decisions for patients with AA.

Keywords: alopecia areata; atopic dermatitis; autoimmune diseases; incidence; prevalence.