| Backgrounds and ObjectivesAlopecia areata(AA) is a common chronic, relapsing, inflammatory, and nonscarring hair loss disorder. Currently, the pathogenesis of AA is not fully understood, but genetic predisposition, immunological processes and environmental factors may play an important role. Although numerous treatments are available for AA, few can cure this disorder. Dermatologists’ preferences regarding treatment of AA were shown to be inconsistent in a cross-sectional survey of the Southeastern United States. However, there are no studies in the Chinese population that assess dermatologists’ preferences in the treatment of AA.More studies have indicated that AA can significantly affect patients’ quality of life, and lead to various psychological problems. The Dermatology Life Quality Index(DLQI) is a simple, easy and commonly used instrument to assess quality of life of patients with skin diseases, whereas the Symptom Checklist 90(SCL-90) is generally used to evaluate psychological status of the population. Both DLQI(Chinese version) and SCL-90(Chinese version) showed a high reliability and validity. However, any measurement instrument should have its reliability and validity re-tested, as they can show different reliabilities and validities in different samples or diseases. Now few studies have reported the reliability or validity of the DLQI and SCL-90 within AA samples. In the present study, we aim to investigate the influence on quality of life and psychological status of patients with AA and dermatologists’ preferences regarding treatment of AA by the method of questionnaire survey, and we performed reliability and validity analysis of DLQI and SCL-90, which can provide theoretical basis for DLQI and SCL-90 application in patients with AA, and for management of AA.Methods and results1. Questionnaires were done in 168 cases of alopecia areata with DLQI. The average score of DLQI was 6.82. Reliability analysis showed that the Cronbach’s α value was 0.88.Factor analysis produced 2 factors with eigenvalues >1.0, which explained 59.58% of the variance.2. The psychological status of 168 patients and 100 controls was evaluated with the SCL-90. The average total score and nine subscale scores on the SCL-90 were significantly higher in AA patients than controls. Reliability analysis indicated that Cronbach’s α value of the whole scale was 0.98 and split-half coefficient was 0.95. The inter-correlations between the nine subscales and their correlations with the total scale were 0.51 ?0.93. Factor analysis indicated that there were 22 dimensions with eigenvalues greater than 1.0, the first factor accounted for 33.88% of the variances.3. We performed a questionnaire survey about treatment of dermatologists’ preferences for AA treatment. The frequency of AA treatment increased with progressive disease severity. Compared with children, adults with AA treated more frequently for first and multiple episodes patchy hair loss. Only a small minority of dermatologists recommended wigs or eyebrow tattoos for patients. Compound glycyrrhizin tablet was the most commonly recommended drug for treatment AA. The most commonly used medications by dermatologists for treatment of AA are variable according to age groups and severity of disease.Conclusion1. AA has a moderate impact on the quality of life in patients. DLQI can be applied to evaluate the influence on quality of life in AA patients.2. Patients with AA seem to experience a lot of psychological problems. SCL-90 can be used to assess global distress in AA patients.3. Dermatologists’ preferences in treatment of AA are not completely consistent. AA is considered as a psychosomatic disease, a multipronged approach is therefore warranted in the management of patients with AA. |
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