Latinx, Hispanic Patients with Alopecia Carry Greater Disease Burden Than White Patients

Latinx and Hispanic patients with alopecia areata are historically underrepresented in research, according to researchers.

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In a letter to be published in the Journal of the American Academy of Dermatology, a group of researchers presented a cross-sectional analysis¹ of existing data supporting the underrepresentation of these populations, as well as statistics on comorbidities, burden of disease, and more.

Inspired by a December 2022 study² published in the same journal, researchers sought to expand upon and add to prior research. In the prior study, entitled “Epidemiology of alopecia areata in 104 Hispanic/Latinx patients,” researchers Phong et al analyzed a cohort of underrepresented patients with alopecia areata.

In order to expand upon this existing data, researchers analyzed data from Latinx and Hispanic patients from a data initiative called All of Us.³ 

All of Us is a collection of data put together by the National Institutes of Health that holds biomedical health data collated from 1 million Americans.

From this database, researchers identified cases of alopecia areata and obtained data from individuals who had self-reported as Latinx or Hispanic. Using electronic medical records, researchers obtained demographic and comorbidity data.

From the All of Us research program, researchers obtained information on a total of 280 Latinx or Hispanic- identifying patients with alopecia areata.

Researchers gathered demographic data on age, sex, education attainment, history of smoking, household income, and insurance coverage.

They also gathered data on alopecia coupled with several common comorbidities, including anxiety, depression, GERD, hyperlipidemia, hypertension, hypothyroidism, IBD, rheumatoid arthritis, systemic lupus erythematosus, and types 1 and 2 diabetes. Of these, rheumatoid arthritis was the most common autoimmune comorbidity. This finding supports Phong et al.’s prior research.

Following their analysis, researchers found that Latinx and Hispanic patients with alopecia areata more commonly experienced anxiety and depression.

“Altogether, we show [Hispanic/Latinx] H/L [alopecia areata] AA patients, compared to controls, to have lower educational attainment, lower prevalence of smoking, and increased rates of autoimmune disease, hyperlipidemia, hypertension, and psychiatric illness,” researchers wrote.

Potential analysis limitations, as identified by researchers, include their inability to determine disease-specific details, such as severity and other characters of cases of alopecia areata. Additionally, temporality between atopic dermatitis and comorbidities was unclear and unestablished.

“We have previously shown H/L AA patients to carry a significant burden of atopic disease, more so than White patients with AA," researchers wrote. "We hope that our findings, together with those of Phong et al., galvanize further research into the epidemiology of AA in the H/L community.”

Reference

1. Joshi TP, Garcia D, Gedeon F, Hinson D, Strouphauer E, Okundia F, Tschen J, Epidemiology of alopecia areata in the Hispanic/Latinx community: A cross-sectional analysis of the All of Us database. J Am Acad Dermatol (2023), doi:https:// doi.org/10.1016/j.jaad.2023.02.054.
2. Phong CH, McMichael AJ, Mesinkovska NA. Epidemiology of alopecia areata in 104 Hispanic/Latinx patients. J Am Acad Dermatol. 2022 Dec 14:S0190-9622(22)02976-0. 105 doi: 10.1016/j.jaad.2022.10.049
3. Denny JC, Rutter JL, Goldstein DB, et al, All of Us research program investigators. The 107 ‘‘all of us’’ research program. N Engl J Med. 2019;381:668-676