Abstract：
Alopecia areata (AA), an autoimmune disease -affecting the hair of the scalp, face, and/or body, can entail substantial psychological and physical burden for patients. There is currently no international agreement on how to treat AA and the approach may vary across countries. This study investigated the management of AA in clinical practice. Data from a point-in-time survey conducted in France, Germany, Italy, Spain, and the United Kingdom, between October 2021-June 2022, were analysed for adults with mild, moderate, and severe AA, based on physician assessment. Dermatologists were surveyed about factors used to assess disease severity, physician-reported treatment goals, and treatment patterns for AA, including the use of wigs. In total, 239 dermatologists reported on 2,083 patients. Physicians\' severity assessment and treatment goals were predominantly driven by scalp hair loss. Topical and intralesional corticosteroids were the most prescribed treatments for mild and moderate AA. Conventional immunosuppressants, oral Janus kinase inhibitors, and topical immunotherapy use generally increased with AA severity and therapy line. Wig use was greatest for severe AA. The primary reasons for the last treatment change in the moderate and severe groups were worsening of condition, lack of initial efficacy, and loss of response, and for mild group were improvement in condition, lack of initial efficacy, and worsening of condition. Findings were generally similar across countries. This analysis provides insights into the management of AA in five European countries and confirms the need for more effective therapies, especially for patients with severe AA.
摘要：
斑秃(AA),一种自身免疫性疾病-影响头皮的头发，脸,和/或身体，可能给患者带来巨大的心理和生理负担。目前没有关于如何治疗AA的国际协议，不同国家的方法可能有所不同。这项研究调查了临床实践中AA的管理。来自法国进行的时间点调查的数据，德国,意大利,西班牙,和英国，2021年10月至2022年6月，对患有轻度、中度,严重的AA，基于医生的评估。皮肤科医生调查了用于评估疾病严重程度的因素，医生报告的治疗目标，以及AA的治疗模式，包括假发的使用。总的来说,239名皮肤科医生报告了2,083名患者。医生的严重程度评估和治疗目标主要由头皮脱发驱动。局部和病灶内皮质类固醇是轻度和中度AA的最常用治疗方法。常规免疫抑制剂,口服Janus激酶抑制剂，局部免疫疗法的使用通常随着AA严重程度和治疗路线的增加而增加。假发的使用对于严重的AA是最大的。中、重度组末次治疗改变的主要原因是病情恶化,缺乏初步疗效，失去反应，对于轻度组，病情有所改善，缺乏初步疗效，和恶化的情况。各国的调查结果普遍相似。此分析提供了对五个欧洲国家AA管理的见解，并证实了对更有效疗法的需求，尤其是严重AA患者。
