The Alopecia Areata Consensus of Experts (ACE) study part II: Results of an international expert opinion on diagnosis and laboratory evaluation for alopecia areata - 07/05/21
Doi : 10.1016/j.jaad.2020.09.028
Nekma Meah, MBChB, MRCP (UK), FACD a, ⁎ 
, Dmitri Wall, MBBCh, BAO, MRCP b, c, Katherine York, MBBCh, FCDerm (SA) d, Bevin Bhoyrul, MBBS, MRCP (UK) a, Laita Bokhari, MPhil Med a, Daniel Asz-Sigall, MD e, Wilma F. Bergfeld, MD f, Regina C. Betz, MD g, Ulrike Blume-Peytavi, MD h, Valerie Callender, MD, FAAD i, Vijaya Chitreddy, FACD a, Andrea Combalia, MD j, George Cotsarelis, MD k, Brittany Craiglow, MD l, m, Jeff Donovan, MD, PhD n, Samantha Eisman, MBChB, MRCP, FACD a, Paul Farrant, MBBS, BSc, MRCP o, Jack Green, FACD p, Ramon Grimalt, MD, PhD q, Matthew Harries, PhD, FRCP r, s, t, Maria Hordinsky, MD, FAAD u, Alan D. Irvine, MD DSc v, Satoshi Itami, MD, PhD w, Victoria Jolliffe, MA(Cantab), FRCP, FRCS(Ed), MRCGP, SFHEA x, Brett King, MD, PhD y, Won-Soo Lee, MD, PhD z, Amy McMichael, MD aa, Andrew Messenger, MD, FRCP bb, Paradi Mirmirani, MD cc, Elise Olsen, MD dd, Seth J. Orlow, MD, PhD ee, Bianca Maria Piraccini, MD, PhD ff, Adriana Rakowska, MD gg, Pascal Reygagne, MD hh, Janet L. Roberts, MD, FAAD ii, Lidia Rudnicka, MD, PhD gg, Jerry Shapiro, MD, FAAD ee, Pooja Sharma, MBBS, FACD a, Antonella Tosti, MD jj, Annika Vogt, MD h, Martin Wade, FACD kk, Leona Yip, MBChB, PhD, FACD ll, Abraham Zlotogorski, MD mm, Rodney D. Sinclair, MBBS, MD, FACD a
, Dmitri Wall, MBBCh, BAO, MRCP b, c, Katherine York, MBBCh, FCDerm (SA) d, Bevin Bhoyrul, MBBS, MRCP (UK) a, Laita Bokhari, MPhil Med a, Daniel Asz-Sigall, MD e, Wilma F. Bergfeld, MD f, Regina C. Betz, MD g, Ulrike Blume-Peytavi, MD h, Valerie Callender, MD, FAAD i, Vijaya Chitreddy, FACD a, Andrea Combalia, MD j, George Cotsarelis, MD k, Brittany Craiglow, MD l, m, Jeff Donovan, MD, PhD n, Samantha Eisman, MBChB, MRCP, FACD a, Paul Farrant, MBBS, BSc, MRCP o, Jack Green, FACD p, Ramon Grimalt, MD, PhD q, Matthew Harries, PhD, FRCP r, s, t, Maria Hordinsky, MD, FAAD u, Alan D. Irvine, MD DSc v, Satoshi Itami, MD, PhD w, Victoria Jolliffe, MA(Cantab), FRCP, FRCS(Ed), MRCGP, SFHEA x, Brett King, MD, PhD y, Won-Soo Lee, MD, PhD z, Amy McMichael, MD aa, Andrew Messenger, MD, FRCP bb, Paradi Mirmirani, MD cc, Elise Olsen, MD dd, Seth J. Orlow, MD, PhD ee, Bianca Maria Piraccini, MD, PhD ff, Adriana Rakowska, MD gg, Pascal Reygagne, MD hh, Janet L. Roberts, MD, FAAD ii, Lidia Rudnicka, MD, PhD gg, Jerry Shapiro, MD, FAAD ee, Pooja Sharma, MBBS, FACD a, Antonella Tosti, MD jj, Annika Vogt, MD h, Martin Wade, FACD kk, Leona Yip, MBChB, PhD, FACD ll, Abraham Zlotogorski, MD mm, Rodney D. Sinclair, MBBS, MD, FACD a a Sinclair Dermatology, East Melbourne, Victoria, Australia
b Hair Restoration Blackrock, Ireland
c National and International Skin Registry Solutions (NISR), Ireland
d Netcare Greenacres Hospital, Port Elizabeth, South Africa
e Dermalomas Clinic, Mexico City, Mexico
f Cleveland Clinic Main Campus, Cleveland, Ohio
g Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital, Bonn, Germany
h Department of Dermatology, Venerology and Allergology, Clinical Research Center for Hair and Skin Science, Charité-Universitaetsmedizin Berlin, Berlin, Germany
i Callender Dermatology and Cosmetic Center, Glenn Dale, Maryland
j Department of Dermatology, Hospital Clinic de Barcelona, Barcelona, Spain
k Department of Dermatology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
l Dermatology Physicians of Connecticut, Farifield, Connecticut
m Yale Department of Dermatology, New Haven, Connecticut
n Donovan Hair Clinic, Canada
o Brighton and Sussex University Hospitals Trust, United Kingdom
p Department of Dermatology, St. Vincent's Hospital, Victoria, Australia
q Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya Josep Trueta s/n 08195 Sant Cugat del Vallès, Barcelona, Spain
r Centre for Dermatology Research, University of Manchester, MAHSC and NIHR Manchester, Manchester, United Kingdom
s Biomedical Research Centre, Manchester, United Kingdom
t The Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
u Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota
v Clinical Medicine, Trinity College Dublin, Ireland
w Department of Dermatology, Oita University, Idaigaoka, Yufu City, Oita, Japan
x Centre for Cell Biology and Cutaneous Research, Blizard Institute, London, United Kingdom
y Yale School of Medicine, New Haven, Connecticut
z Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
aa Wake Forest University School of Medicine, Winston-Salem, North Carolina
bb Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, United Kingdom
cc Kaiser Permanente Vallejo, Department of Dermatology, California
dd Duke Dermatology Clinic–Clinic 3K, Durham, North Carolina
ee The Ronald O. Perelman Department of Dermatology at NYU Grossman School of Medicine, New York, New York
ff International Relations, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Dermatology Unit, Bologna, Italy
gg Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
hh Centre de santé Sabouraud, Hôpital Saint Louis, Paris, France
ii Northwest Dermatology Institute Portland, Portland, Oregon
jj Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine
kk The London Skin and Hair Clinic, London, United Kingdom
ll Skin Partners Specialist Dermatologists, Brisbane, Queensland, Australia
mm Department of Dermatology, Hadassah Medical Center, Hebrew University of Jerusalem, The Faculty of Medicine, Jerusalem, Israel
∗Correspondence to: Nekma Meah, MBChB, MRCP (UK), FACD, Sinclair Dermatology, 2 Wellington Parade, East Melbourne, Victoria 3002, Australia.Sinclair Dermatology2 Wellington ParadeEast MelbourneVictoria3002Australia
Abstract |
Background |
We previously reported the Alopecia Areata Consensus of Experts study, which presented results of an international expert opinion on treatments for alopecia areata.
Objective |
To report the results of the Alopecia Areata Consensus of Experts international expert opinion on diagnosis and laboratory evaluation for alopecia areata.
Methods |
Fifty hair experts from 5 continents were invited to participate in a 3-round Delphi process. Consensus threshold was set at greater than or equal to 66%.
Results |
Of 148 questions, expert consensus was achieved in 82 (55%). Round 1 consensus was achieved in 10 of 148 questions (7%). Round 2 achieved consensus in 47 of 77 questions (61%). The final face-to-face achieved consensus in 25 of 32 questions (78%). Consensus was greatest for laboratory evaluation (12 of 14 questions [86%]), followed by diagnosis (11 of 14 questions [79%]) of alopecia areata. Overall, etiopathogenesis achieved the least category consensus (31 of 68 questions [46%]).
Limitations |
The study had low representation from Africa, South America, and Asia.
Conclusion |
There is expert consensus on aspects of epidemiology, etiopathogenesis, clinical features, diagnosis, laboratory evaluation, and prognostic indicators of alopecia areata. The study also highlights areas where future clinical research could be directed to address unresolved hypotheses in alopecia areata patient care.
Le texte complet de cet article est disponible en PDF.Key words : alopecia areata, assessment, consensus, Delphi, guideline
Abbreviation used : ACE
Plan
| Drs Meah and Wall are cofirst authors. |
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| Funding sources: Dr Betz is funded by the Deutsche Forschungsgemeinschaft (German Research Foundation) under the auspices of the Germany Excellence Strategy–EXC2151-390873048. Dr Harries is supported by the NIHR Manchester Biomedical Research Centre. Supported in part by an educational grant from The Australasian Hair and Wool Research Society. |
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| Conflicts of interest: Dr Wall has received honoraria from Janssen, consultancy fees from Eli Lilly and Company, and travel fees and a grant from Pfizer; he has also received personal fees for consultancy from the nonprofit company National and International Skin Registry Solutions (NISR). Dr Blume-Peytavi has received honoraria and consultancies from Abbvie, Bayer, Galderma, Pfizer, Pierre Fabre Dermocosmetics, Sanofi, and Regeneron, none relevant to this work. Dr Callender is principal investigator for the Lilly Clinical Trial. Dr Cotsarelis is coinvestigator in a clinical trial sponsored by Lilly. Dr Craiglow has received honoraria and/or fees from Aclaris, Arena Pharmaceuticals, Pfizer, Regeneron, and Sanofi-Genzyme. Dr Eisman has been principal investigator in clinical trials for Pfizer Inc, AbbVie, Arena Pharmaceuticals, Boston Pharmaceuticals, Bristol-Myers Squibb, Botanix, Dermira, Eli Lilly and Company, Leo Pharma, Novartis, and Regeneron. Dr Farrant is a consultant for Lilly and principal investigator for Pfizer in clinical research studies. Dr Irvine has received honoraria and consultancies from Pfizer, Novartis, AbbVie, Sanofi, and Regeneron, none relevant to this work. Dr King is an investigator for Concert Pharmaceuticals Inc, Eli Lilly and Company, and Pfizer Inc; he is a consultant to and/or has served on advisory boards for Aclaris Therapeutics, Arena Pharmaceuticals, Bristol-Meyers Squibb, Concert Pharmaceuticals Inc, Dermavant Sciences, Eli Lilly and Company, and Pfizer Inc; he is on speaker's bureau for Pfizer Inc, Regeneron, and Sanofi Genzyme. Dr McMichael has received personal fees for consultancy work with Bioniz, Pfizer, and Revian, in addition to personal fees and grants from Aclaris, Concert, Galderma, Allergan, Almirall, Cassiopea, Incyte, Procter and Gamble, and Revian. Dr Messenger reports consultancies with Pfizer and Manentia. Dr Mirmirani has been an investigator for Concert Pharmaceuticals, Pfizer, and Eli Lilly and Company. Dr Olsen reports being an Aclaris investigator and Arena consultant. Dr Shapiro reports being a consultant and investigator for Pfizer and received an honorarium for consultancy for Pfizer and Lilly. Dr Sharma reports being a subinvestigator for Pfizer and Lilly. Dr Tosti reports being a consultant for DS Laboratories, Monat Global, Almirall, Tirthy Madison, Lilly, Leo Pharmaceuticals, Bristol Myers Squibb, and Proctor and Gamble. Dr Sinclair has served as a consultant or paid speaker for, or participated in clinical trials sponsored by, Leo Pharma, Amgen, Novartis, Merck & Co, Celgene, Coherus Biosciences, Janssen, Regeneron, MedImmune, GlaxoSmithKline, Cutanea, Samson Clinical, Boehringer Ingelheim, Pfizer, MSD, Oncobiologics, Roche, Eli Lilly and Company, and Bayer. Drs Asz-Sigall, Bergfeld, Betz, Combalia, Donovan, Grimalt, Harries, Hordinsky, Itami, Lee, Orlow, Piraccini, Rakowska, Reygagne, Roberts, Rudnicka, Vogt, Yip, and Zlotogorski, and Authors Meah, York, Bhoyrul, Bokhari, Chitreddy, Green, Jolliffe, and Wade have no conflicts of interest to declare. |
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| IRB approval status: Not applicable. |
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| Reprints not available from the authors. |
© 2020
American Academy of Dermatology, Inc. Tous droits réservés.
Vol 84 - N° 6
P. 1594-1601 - juin 2021 Retour au numéro
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