Development of the alopecia areata scale for clinical use: Results of an academic–industry collaborative effort

Brett A. King, Natasha Atanaskova Mesinkovska, Brittany Craiglow, Chesahna Kindred, Justin Ko, Amy McMichael, Jerry Shapiro, Carolyn Goh, Paradi Mirmirani, Antonella Tosti, Maria Hordinsky, Kathie P. Huang, Leslie Castelo-Soccio, Wilma Bergfeld, Amy S. Paller, Julian Mackay-Wiggan, Marc Glashofer, Crystal Aguh, Melissa Piliang, Pedram YazdanKristen Lo Sicco, James V. Cassella, Justine Koenigsberg, Gurpreet Ahluwalia, Eric Ghorayeb, Steven Fakharzadeh, Lynne Napatalung, Kavita Gandhi, Amy M. DeLozier, Fabio P. Nunes, Maryanne M. Senna

Research output: Contribution to journalArticlepeer-review

29 Scopus citations


Background: The current classification for alopecia areata (AA) does not provide a consistent assessment of disease severity. Objective: To develop an AA severity scale based on expert experience. Methods: A modified Delphi process was utilized. An advisory group of 22 AA clinical experts from the United States was formed to develop this AA scale. Representatives from the pharmaceutical industry provided feedback during its development. Results: Survey responses were used to draft severity criteria, aspiring to develop a simple scale that may be easily applied in clinical practice. A consensus vote was held to determine the final AA severity statement, with all AA experts agreeing to adopt the proposed scale. Limitations: The scale is a static assessment intended to be used in clinical practice and not clinical trials. Conclusion: The final AA disease severity scale, anchored in the extent of hair loss, captures key features commonly used by AA experts in clinical practice. This scale will better aid clinicians in appropriately assessing severity in patients with this common disease.

Original languageEnglish
Pages (from-to)359-364
Number of pages6
JournalJournal of the American Academy of Dermatology
Issue number2
StatePublished - Feb 2022
Externally publishedYes


  • alopecia areata
  • clinical practice
  • consensus
  • severity


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