16 Journal of the European Academy of Dermatology & Venereology, 3 (1994) 16-21 © 1994 Elsevier Science B.V. All rights reserved 0926-9959/94/$07.00 DERVEN 00111 Alopecia areata and stress in children F.B. De Waard-Van der Spek \ D.M.J. De Raeymaecker ^ H.M. Koot '' and A.P. Oranje " Departments of " Dermatology and Venereology * Child and Adolescent Psychiatry, University Hospital Rotterdam, Dijkzigt /Sophia Children's Hospital, Rotterdam The Netherlands Abstract Background The role of psychological factors is conflicting in alopecia areata (AA). Acute as well as chronic stress have been observed in patients with AA. Design A descriptive study of psychological and social factors which may play a role in the pathogenesis and prognosis of childhood AA. Seventeen patients with AA were dermatologi- cally examined and psychosocially studied. Behavioral and emotional problems and possible psychopathology in the child's actual functioning were scored with the Child Behavior Checklist (CBCL) and a life events scale. Fifteen patients with visible atopic dermatitis (AD) formed a reference group. Results Although, on average, children with AA do not have higher behavior problem scores than children in the normative group, more children had scores in the clinical range. However, AA and AD children did not differ in this respect. More AA and AD children than children in the normative group had low social competence scores. Thus, although some AA children differ from children from the normative group, this difference is not specific compared with other children with affected skin, i.e., the AD group. The mean total score and the mean number of life events did not differ significantly from the corresponding data on the interna- tional control population. Conclusion A tendency was observed that psychosocial factors play a role in maintaining or inducing AA and AD. Key words: Alopecia areata; Atopic dermatitis; Stress; Psychosocial factor; Child behavior check list; Life events scale Introduction Correspondence to: F.B. De Waard-Van der Spek, ., . ... / A A \ • ^ • Department of Dermatology and Venereology, Univer- Alopecia areata (AA) IS an auto-immune sity Hospital Rotterdam, Dijkzigt/Sophia Children's scalp disease which can affect any hairy part Hospital, Rotterdam, The Netherlands. of the skin. The onset is often characterized SSDI 0926-9959(93)E0035-J