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Background The aim of this study was to estimate whether the stress, lack of social support, and poor emotional relationships influence the recurrence of AD in adults. Methods Case-control study comprised 66 outpatients with AD and 132 controls with different skin diseases believed to be slightly influenced by psychosomatic factors. Participants were treated at the Department of Dermatology - Military Medical Academy and City Department for Skin and Venereal Diseases from January to June 2014. Stressful life events were assessed using the Paykel's Interview for Recent Life Events. The attachment relationship and perceived social support were assessed with the Experiences in Close Relationships Scale and with the Multidimensional Scale of Perceived Social Support, respectively. Univariate and multivariate logistic regression analyses were applied. Results AD patients had significantly higher anxiety scores when initiating a close emotional relationship and when avoiding an affective attachment (OR = 1.49; CI = 1.13-1.97; P = 0.005 and OR = 1.63; CI = 1.16-2.30; P = 0.005, respectively). Perceived social support from family and friends was significantly lower among cases compared to controls (OR = 0.93; CI = 0.88-0.98; P = 0.009 and UO = 0.94; CI = 0.89-0.99; P = 0.027, respectively). Conclusions AD patients had higher anxiety scores, and those with low social support tended to have more frequent disease recurrence. The number of stressful life events did not differ between studied groups.

Background Previous studies suggest that alopecia areata (AA) may significantly affect patient quality of life (QoL). There are no studies that assess QoL in Serbian AA patients. Objectives This study aims to assess the impact of AA on patients' QoL in comparison to patients affected by other skin diseases and to determine the impact of sociodemographic and clinical characteristics of AA patients on QoL. Methods A hospital-based cross-sectional study of 60 patients with AA was conducted at the Clinic of Dermatovenereology, Clinical Center of Serbia, Belgrade between April 2012 and June 2013. The severity of hair loss was assessed using the Severity of Alopecia Tool (SALT). Patients' self-assessment of QoL was measured by three self-administered questionnaires: The Short Form-36 Health Survey (SF-36), Dermatology Life Quality Index (DLQI) and The Skindex-29. Results Sixty AA patients (16 males and 44 females) with mean age of 37.35 ± 14.26 years completed the questionnaires. We confirmed that QoL of our AA patients was impaired. Compared with patients suffering from psoriasis, atopic dermatitis and onychomycosis AA patients presented significantly better QoL. Severity of disease (SALT) correlated only with personal relationship – dimension of DLQI (ρ = 0.29, P < 0.05) and social functioning – dimension of Skindex (ρ = 0.26, P < 0.05). No correlation was observed between severity of the disease and SF-36 subscales. AA patients with depression had significantly worse QoL in daily activities, leisure, work or school and personal relationships – DLQI dimensions, and emotions and social functioning – Skindex subscales. Conclusion Our study demonstrates that AA influences QoL, but to a lesser degree than observed for psoriasis, atopic dermatitis and onychomycosis.