{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T09:06:06Z","timestamp":1779786366035,"version":"3.53.1"},"reference-count":23,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background: Alopecia areata (AA) is a chronic autoimmune disorder characterized by non-scarring hair loss and commonly coexists with other autoimmune diseases, suggesting systemic immune dysregulation. An association between AA and iron deficiency anemia (IDA) has been proposed, though prior studies have yielded conflicting results. Objective: Our aim was to examine the association between AA and IDA in a large, population-based cohort. Methods: We conducted a retrospective case\u2013control study using data from a health maintenance organization (HMO) serving approximately 2.35 million individuals. We included 33,401 AA patients diagnosed between 2005 and 2019, matched 1:2 by age and sex with 66,802 controls without AA. Diagnoses of AA and IDA were confirmed through clinical coding by board-certified dermatologists and primary care physicians. Statistical analyses employed Kruskal\u2013Wallis, Pearson\u2019s \u03c72, and Fisher\u2019s exact tests. Results: IDA prevalence was significantly higher in AA patients than in controls (15% vs. 10%; OR 1.61, 95% CI: 1.55\u20131.67; p &lt; 0.01). IDA preceded AA in 40% of cases, followed AA in 58%, and occurred concurrently in 2%. Limitations: The retrospective design limits causal inference. Conclusion: This study reinforces an association between AA and IDA, highlighting the need to assess and manage IDA as a potential treatable comorbidity in AA patients.<\/jats:p>","DOI":"10.3390\/jpm16060283","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T08:16:08Z","timestamp":1779783368000},"page":"283","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association Between Alopecia Areata and Iron Deficiency Anemia: A Large-Scale Population-Based Case\u2013Control Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7488-035X","authenticated-orcid":false,"given":"Batya","family":"Davidovici","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Division of Dermatology, Rabin Medical Center\u2014Beilinson Hospital, Petach Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yarden","family":"Drutin","sequence":"additional","affiliation":[{"name":"Pediatrics Department, Dana-Dwek Children\u2019s Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9627-7626","authenticated-orcid":false,"given":"Amir","family":"Ben-Tov","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Maccabi Health Services, Tel-Aviv 6812509, Israel"},{"name":"Kahn Sagol Maccabi Research and Innovation Center, Maccabi Healthcare Services, Tel-Aviv 6423906, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7158-2085","authenticated-orcid":false,"given":"Daniel","family":"Mimouni","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"Division of Dermatology, Rabin Medical Center\u2014Beilinson Hospital, Petach Tikva 4941492, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8817-3162","authenticated-orcid":false,"given":"Yonit","family":"Wohl","sequence":"additional","affiliation":[{"name":"Maccabi Health Services, Tel-Aviv 6812509, Israel"},{"name":"Kahn Sagol Maccabi Research and Innovation Center, Maccabi Healthcare Services, Tel-Aviv 6423906, Israel"},{"name":"Faculty of Medicine, Ariel University, Ariel 4070000, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"397","DOI":"10.2147\/CCID.S53985","article-title":"Epidemiology and burden of alopecia areata: A systematic review","volume":"8","author":"Miteva","year":"2015","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/1346-8138.16606","article-title":"Prevalence of alopecia areata in Japan: Estimates from a nationally representative sample","volume":"50","author":"Aranishi","year":"2023","journal-title":"J. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1136\/bmj.331.7522.951","article-title":"The psychological impact of alopecia","volume":"331","author":"Hunt","year":"2005","journal-title":"BMJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1038\/jidsymp.2013.4","article-title":"Overview of alopecia areata","volume":"16","author":"Hordinsky","year":"2013","journal-title":"J. Investig. Dermatol. Symp. Proc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1159\/000485080","article-title":"Immune privilege collapse and alopecia development: Is stress a factor?","volume":"4","author":"Azzawi","year":"2018","journal-title":"Ski. Appendage Disord."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1016\/j.jaci.2015.06.032","article-title":"Alopecia areata profiling shows TH1, TH2, and IL-23 cytokine activation without parallel TH17\/TH22 skewing","volume":"136","author":"Ungar","year":"2015","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_7","first-page":"167","article-title":"Increased incidence of thyroid disease in patients with alopecia areata: A systematic review and meta-analysis","volume":"235","author":"Xin","year":"2019","journal-title":"Dermatology"},{"key":"ref_8","first-page":"336","article-title":"Italian National Registry of Alopecia Areata: An epidemiological study of 699 Italian patients","volume":"159","author":"Piraccini","year":"2024","journal-title":"Ital. J. Dermatol. Venerol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1111\/1346-8138.13165","article-title":"Follow-up study on the relationship between alopecia areata and risk of autoimmune diseases","volume":"43","author":"Chen","year":"2016","journal-title":"J. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.jaad.2009.04.031","article-title":"History of atopy or autoimmunity increases risk of alopecia areata","volume":"61","author":"Barahmani","year":"2009","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"552","DOI":"10.4103\/0378-6323.55430","article-title":"Serum vitamin B12, folate, ferritin, and iron levels in Turkish patients with alopecia areata","volume":"75","author":"Gonul","year":"2009","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref_12","first-page":"92","article-title":"Serum iron and ferritin levels in alopecia areata","volume":"14","author":"Nighat","year":"2011","journal-title":"Iran. J. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1016\/j.jaad.2018.07.013","article-title":"Comorbidities in alopecia areata: A systematic review and meta-analysis","volume":"80","author":"Lee","year":"2019","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e70076","DOI":"10.1111\/jocd.70076","article-title":"Global burden of alopecia areata and associated diseases: A trend analysis from 1990 to 2021","volume":"24","author":"Zhou","year":"2025","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3362","DOI":"10.1097\/MS9.0000000000003100","article-title":"Iron homeostasis and health: Understanding its role beyond blood health\u2014A narrative review","volume":"87","author":"Obeagu","year":"2025","journal-title":"Ann. Med. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1080\/03007995.2020.1748585","article-title":"Newly diagnosed iron deficiency anemia and subsequent autoimmune disease: A matched cohort study in Taiwan","volume":"36","author":"Chang","year":"2020","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1016\/j.jaad.2005.11.1104","article-title":"The diagnosis and treatment of iron deficiency and its potential relationship to hair loss","volume":"54","author":"Trost","year":"2006","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1046\/j.1523-1747.2003.12540.x","article-title":"Decreased serum ferritin is associated with alopecia in women","volume":"121","author":"Kantor","year":"2003","journal-title":"J. Investig. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Kolar\u0161, B., Mijatovi\u0107 Jovin, V., \u017divanovi\u0107, N., Minakovi\u0107, I., Gvozdenovi\u0107, N., Dickov Kokeza, I., and Lesjak, M. (2025). Iron Deficiency and Iron Deficiency Anemia: A Comprehensive Overview of Established and Emerging Concepts. Pharmaceuticals, 18.","DOI":"10.3390\/ph18081104"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1007\/s12016-017-8620-9","article-title":"Alopecia Areata: A Comprehensive Review of Pathogenesis and Management","volume":"54","author":"Dias","year":"2018","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s40257-023-00764-w","article-title":"Efficacy and safety of baricitinib in patients with severe alopecia areata over 52 weeks of continuous therapy in two phase III trials (BRAVE-AA1 and BRAVE-AA2)","volume":"24","author":"Kwon","year":"2023","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1016\/S0140-6736(23)00222-2","article-title":"Efficacy and safety of ritlecitinib in adults and adolescents with alopecia areata: A randomized, double-blind, multicentre, phase 2b\u20133 trial","volume":"401","author":"King","year":"2023","journal-title":"Lancet"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1016\/j.jaad.2024.06.097","article-title":"Efficacy and safety of deuruxolitinib, an oral selective Janus kinase inhibitor, in adults with alopecia areata: Results from the phase 3 randomized controlled trial (THRIVE-AA1)","volume":"91","author":"King","year":"2024","journal-title":"J. Am. Acad. Dermatol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/6\/283\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T08:41:09Z","timestamp":1779784869000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/16\/6\/283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":23,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jpm16060283"],"URL":"https:\/\/doi.org\/10.3390\/jpm16060283","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]}}}