Introduction: Alopecia areata (AA) is a disfiguring disease with substantial psychological burden. Few studies explore the interaction between AA symptoms and health-related quality of life (HRQOL) using both disease-specific and generic quality of life instruments.
Objective: To evaluate impairments on quality of life dimensions using both generic and disease-specific measures.
Materials and Methods: Participants with moderate to severe AA from a placebo-controlled randomised trial were administered the generic HRQOL instrument, Assessment of Quality of Life-8D (AQoL-8D) and the disease-specific HRQOL instrument, Alopecia Areata Symptom Impact Scale (AASIS) at baseline and analysed. Health state utility scores were calculated using an Australian-specific tariff for the AQoL-8D and each dimension was compared with Australian population norms. Global Symptom Impact (GSI) Score and Global Interference (GI) Score were calculated from the AASIS and correlated to the AQoL-8D utility score.
Results: 36 participants were analysed. Participants had on average impaired HRQOL across 6 of 8 AQoL-8D dimensions compared to Australian population norms. Mental health, self-worth and coping were most affected. Only independent living and pain were not impaired compared to Australian population norms. AA most substantially interferes with enjoyment of life, interpersonal interaction and work as measured by AASIS. There was a strong negative correlation between AASIS GSI and GI scores with AQoL-8D utility scores (both Spearman’s correlation coefficient=-0.73).
Conclusions: In moderate to severe AA patients, HRQOL was substantially lower than Australian population norms across 6 of 8 dimensions. Greater symptom severity and greater interference with daily functioning were strongly correlated with poorer HRQOL.