Global Guidelines in Dermatology Mapping Project (GUIDEMAP): a systematic review of alopecia areata clinical practice guidelines.

This article systematically reviews and critically appraises the quality of clinical practice guidelines (CPGs) for alopecia areata (AA), a common immune-mediated nonscarring hair loss condition with significant psychosocial impact. The review identified six AA CPGs published globally between 2014 and 2021, primarily from high sociodemographic index countries, with under-representation from Asia, South America, and Africa. Using three validated appraisal tools—the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument, Lenzer's red flags, and the United States Institute of Medicine's (IOM) criteria of trustworthiness—the study found that all AA CPGs exhibited substantial methodological deficiencies, particularly in stakeholder involvement, rigour of development, applicability, external review, and transparency. The authors recommend that future guideline development groups enhance methodological rigor by including diverse stakeholders (notably patients and methodologists), conducting external reviews, and improving the applicability of recommendations through clear implementation strategies and audit standards.