Determining the Quality of Life of People with Alopecia areata and Associated Factors in Tertiary Hospitals in Capital City of Malaysia
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Abstract
Alopecia areata (AA) is a disabling hair disorder which usually begins in teenage years. Worldwide prevalence is 0.1-0.2%, with no data of prevalence in Malaysia. The aim of this study was to determine the quality of life of people with AA and associated factors in major tertiary hospitals in the capital city of Malaysia. Materials and methods: A cross-sectional study was conducted at three Dermatology Outpatient Clinics in three tertiary hospitals in the capital city of Malaysia over one year starting September 2021. A validated questionnaire incorporating the Dermatology Life Quality Index (DLQI) was used. A total of 150 participants with AA were successfully recruited. Results: The Dermatology Life Quality Index (DLQI) mean score was 28.9 with those scoring 29 and above classified as having a poor quality of life and those scoring 28 or less as having a good quality of life. Univariate and bivariate analysis showed that marital status and presence of diabetes was significantly associated with a poorer quality of life. In multivariate analysis, it was found that those who were not married had 1.39 higher odds of having poor quality of life as compared to those who were married (95% CI 1.23-1.65, p=0.04). It was also found that those with diabetes had 2.99 higher odds of having poor quality of life (95% CI 1.83-4.12, p=0.02). Conclusion: In conclusion, participants with AA who weren’t married and with diabetes had poor quality of life. These findings can help physicians build on the body of literature in managing AA.
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Yin YL, Chew CK. A 10-year retrospective review of non-scarring alopecia in a tertiary hospital in Malaysia. 2012; Malay J Dermatol 29: 12-15. Available from: https://www.dermatology.org.my/pdf/journal%202012%20B1.pdf
Kapadia N, Ahmad TJ, Borhany T. Male androgenetic alopecia treated with finasteride. Journal of Pakistan Association of Dermatologists. 2008;18(4):232-4. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/601
Safavi K. Prevalence of Alopecia areata in the First National Health and Nutrition Examination Survey. Arch Dermatol. 1992 May. 128(5):702. doi: 10.1001/archderm.1992.01680150136027
Safavi KH, Muller SA, Suman VJ, Moshell AN, Melton LJ 3rd. Incidence of Alopecia areata in Olmsted County, Minnesota, 1975 through 1989. Mayo Clin Proc. 1995 Jul. 70(7):628-33. doi:10.4065/70.7.628
Alshahrani AA, Al-Tuwaijri R, Abuoliat ZA, Alyabsi M, AlJasser MI, Alkhodair R. Prevalence and clinical characteristics of Alopecia areata at a tertiary care center in Saudi Arabia. Dermatology research and practice. 2020;2020(1):71942. doi: 10.1155/2020/7194270
Schmidt S, Fischer TW, Chren MM, Strauss BM, Elsner P. Strategies of coping and quality of life in women with alopecia. British Journal of Dermatology. 2001 May 1;144(5):1038-43. doi: 10.1046/j.1365-2133.2001.04195.x
Cash TF, Price VH, Savin RC. Psychological effects of androgenetic alopecia on women: comparisons with balding men and with female control subjects. Journal of the American Academy of Dermatology. 1993 Oct 1;29(4):568-75. doi: 10.1016/0190-9622(93)70223-g
Alfonso M, Richter-Appelt H, Tosti A, Viera MS, García M. The psychosocial impact of hair loss among men: a multinational European study. Current medical research and opinion. 2005 Nov 1;21(11):1829-36. doi: 10.1185/030079905X61820
Eckert J. Diffuse hair loss in women: the psychopathology of those who complain. Acta Psychiatrica Scandinavica. 1976 May;53(5):321-7. doi: 10.1111/j.1600-0447.1976.tb00079.x
Muntyanu A, Gabrielli S, Donovan J, Gooderham M, Guenther L, Hanna S, Lynde C, Prajapati VH, Wiseman M, Netchiporouk E. The burden of alopecia areata: a scoping review focusing on quality of life, mental health and work productivity. Journal of the European Academy of Dermatology and Venereology. 2023 Aug;37(8):1490-520. doi: 10.1111/jdv.18926
Mesinkovska N, Craiglow B, Ball SG, Morrow P, Smith SG, Pierce E, Shapiro J. The invisible impact of a visible disease: psychosocial impact of alopecia areata. Dermatology and therapy. 2023 Jul;13(7):1503-15. doi: 10.1007/s13555-023-00941-z
Sinclair R. Androgenetic alopecia in men and women. Medicine Today. 2004 Oct 1;5(10):48-55. doi: 10.1016/s0738-081x(00)00128-0
Rogers NE, Avram MR. Medical treatments for male and female pattern hair loss. Journal of the American Academy of Dermatology. 2008 Oct 1;59(4):547-66. doi: 10.1016/j.jaad.2008.07.001
Dinh QQ, Sinclair R. Female pattern hair loss: current treatment concepts. Clinical interventions in aging. 2007 Jan 1;2(2):189-99. Available from: https://www.dovepress.com/articles.php?article_id=162
Reid EE, Haley AC, Borovicka JH, Rademaker A, West DP, et al. (2010) Clinical severity does not reliably predict quality of life in women with alopecia areata, telogen effluvLum, or androgenic alopecia. J Am Acad Dermatol 66: e97-102. doi: 10.1016/j.jaad.2010.11.042
Sibbald C. Alopecia areata: an updated review for 2023. Journal of cutaneous medicine and surgery. 2023 May;27(3):241-59. doi: 10.1177/12034754231168839
WHO. The World Health Organization Quality of Life (WHOQOL). Geneva, WHO, 2012. Available from: https://www.who.int/tools/whoqol
Section of Dermatology, Department of Dermatology & Wound Healing, School of Medicine, Cardiff University. Dermatology Life Quality Index (DLQI). Available from: https://www.cardiff.ac.uk/medicine/resources/quality-of-life-questionnaires/dermatology-life-quality-index
Prinsen CA, de Korte J, Augustin M et al. Measurement of health-related quality of life in dermatological research and practice: outcome of the EADV Taskforce on Quality of Life. J Eur Acad Dermatol Venereol 2013; 27(10): 1195-203. doi: 10.1111/jdv.12090
Tsai, TY., Chiu, CJ., Wang, TY. et al. Loneliness and isolated living status in middle-aged and older adults in Taiwan: exploration on stress-related biomarkers, depressive symptoms, and disability. BMC Psychiatry.2022;22(177). https://doi.org/10.1186/s12888-022-03824-3
Kang JE, Graham‐Engeland JE, Scott S, Smyth JM, Sliwinski MJ. The relationship between loneliness and the experiences of everyday stress and stressor‐related emotion. Stress and Health. 2024 Apr;40(2):e3294. https://doi.org/10.1002/smi.3294
Hapunda G. Coping strategies and their association with diabetes specific distress, depression and diabetes self-care among people living with diabetes in Zambia. BMC Endocr Disord. 2022 Aug 28;22(1):215. doi: 10.1186/s12902-022-01131-2.
Kusaslan Avci D. Evaluation of the relationship between loneliness and medication adherence in patients with diabetes mellitus: A cross-sectional study. J Int Med Res. 2018 Aug;46(8):3149-3161. doi: 10.1177/0300060518773223.
Khunti N, Khunti N, Khunti K. Adherence to type 2 diabetes management. British Journal of Diabetes. 2019 Dec 17;19(2):99-104. https://doi.org/10.15277/bjd.2019.223
Hawkley, L.C. Loneliness and health. Nat Rev Dis Primers.2022;8(22). https://doi.org/10.1038/s41572-022-00355-9
Zhang M, Zhang N. Quality of life assessment in patients with Alopecia areata and androgenetic alopecia in the People’s Republic of China. Patient preference and adherence. 2017 Jan 27:151-5. doi: 10.2147/PPA.S121218
Senna M, Ko J, Glashofer M, Walker C, Ball S, Edson-Heredia E, Zhu B, Shapiro J. Predictors of QOL in patients with alopecia areata. Journal of Investigative Dermatology. 2022 Oct 1;142(10):2646-50. doi: 10.1016/j.jid.2022.02.019
Liu LY, King BA, Craiglow BG. Health-related quality of life (HRQoL) among patients with Alopecia areata (AA): a systematic review. Journal of the American Academy of Dermatology. 2016 Oct 1;75(4):806-12. doi: 10.1016/j.jaad.2016.04.035
Rad GS, Bakht LA, Feizi A, Mohebi S. Importance of social support in diabetes care. J Educ Health Promot. 2013 Oct 30;2:62. doi: 10.4103/2277-9531.120864
Thomas PA. The Impact of Relationship-Specific Support and Strain on Depressive Symptoms Across the Life Course. J Aging Health. 2016 Mar;28(2):363-82. doi: 10.1177/0898264315591004.
Bradshaw J, Siddiqui N, Greenfield D, Sharma A. Kindness, Listening, and Connection: Patient and Clinician Key Requirements for Emotional Support in Chronic and Complex Care. Journal of Patient Experience. 2022;9. doi:10.1177/23743735221092627