Korean Consensus Criteria for the Severity Classification of Alopecia Areata

Abstract

Background: A set of criteria for severity classification is essential in alopecia areata (AA). Cur- rently, no guidelines are universally accepted for defining AA severity.

Objective: This study aimed to establish a set of consensus criteria for classif ying the severity of and identif ying treatment refractoriness in AA.

Methods: A preliminar y draft of the definition for moderate-to-severe AA was crafted based on available evidence, and members of the Korean Hair Research Society (KHRS) subsequently endorsed the recommendation through an online sur vey.

Results: In the first Delphi round, consensus was attained on 15 questions. After refining cer- tain items in the second round, consensus was achieved on 23 out of 26 questions. The KHRS first defined AA severity using the severity of alopecia tool (SALT). SALT ≥50 was defined as severe, 20≤ SALT <50 as moderate, and SALT <20 as mild. Moderate AA was considered severe if it meets one or more of the following criteria: dermatology life quality index >10, presence of accompanying eyebrow or eyelash loss, positive hair loss activity, or treatment-refractor y AA.

Conclusion: These consensus criteria can help clinicians accurately diagnose AA, provide appro- priate treatment, and monitor its progression.