الفهرس 
Review of Literature
Alopecia areataOnly 14 pages are availabe for public view
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Abstract
Alopecia areata is a common type of hair loss. It occurs in either sex,
and any age can be affected. It usually presents with an oval patch or
multiple confluent patches of asymptomatic, well-circumscribed, nonscarring
alopecia areata that regrow spontaneously, but may also persist or
progress to all scalp hair alopecia totalis or all body hair, including eyebrows
and eyelashes alopecia universalis.
Although there are several hypotheses proposed the etiology of
AA, many factors have been descried such as genetic susceptibility, the
atopic state, non- specific autoimmune reactions, neurological factors,
infectious agents, and possible emotional stress .
The histologic features of AA vary with the stage of the lesion.
Active patches demonstrate peribulbar lymphocyic infiltrate, a reduction
in the anagen/telogen ratio and miniaturized dystrophic hairs. In later
stage, a reduction in the anagen/telogen ratio, miniaturized hairs, and
many fibrous tracts, some with lymphocytic cells or pigment incontinence
are seen.
Most evidence supports the hypothesis that AA is T-cell mediated
autoimmune disease and their cytokines and chemokine play an important
role. The immune response present in AA is associated with aberrant
lesional expression of IFN-γ, IL-2 and IL-1β and over expression of
ICAM-1 and MHC molecules on hair follicle keratinocytes and dermal
papilla cells. RANTES production is markedly induced through
subsequent stimulation with TNF-α and INF-γ in combination. RANTES
production by keratinocytes may contribute to the recruitment of specific
inflammatory infiltrate as lymphocytes and eosinophils to which
Summary & Conclusion
RANTES is chemotactic and which are involved in the pathogenesis of
AA.
The aim of this study is to evaluate the serum RANTES levels in
patients with AA with or without atopy and comparing their levels with
normal subjects as controls trying to evaluate its role in pathogenesis of
AA and if it could be used as a marker of atopy in AA patients.
This study was carried on 75 subjects, 54 patients with AA and 21
apparently health persons they were 33 females and 42 males with age
ranging from (7-50) years. The patients were attendants of out patients
clinic of Dermatology Department, Menoufiya University hospital during
the period from December 2009 to April 2010 . They were classified into
the following 4 groups :
• Group I: included mono AA patients (one or two lesions). They
are 26 patients (34.66%), 10 females (38.5%) and 16males
(61.5%), their aged ranged between (7-50) years.
• Group II: included poly AA patients (three or more lesions).
They were18 patients (24%), 11 females (61.1%) and 7 males
(38.9%), their aged ranged between (7-47) years.
• Group III: included AT/AU patients (complete loss of body hair ).
they were 10 patients (13.33%), 2 females (20%) and 8 males
(80%) their aged ranged between (17-45) years.
• Group IV: included 21(28%) Age & sex matched healthy subjects
as controls 10 females (47.6%) and 11 males (52.4%). Their ages
were ranged between (7 -50 ) years.
Patients with either spontaneous regrowth of terminal hair at time
of presentation, patients using topical, intralesional or systemic agents as
steroids or immunosuppressive likely to cause regrowth in AA within the
past month or having other types of illness such as autoimmune diseases
Summary & Conclusion
and parisitic infestation were excluded by time of examination.
Each patient was subjected to a detailed history taking and
complete examination to detect type of AA and the extent(SALT score)
of AA in addition to presence or absence of atopy. Blood samples were
taken from all subjects to assess serum RANTES and total IgE and
complete blood count.
The obtained data are tabulated and subjected to statistical analysis
using different tests of significance.
Our results revealed that serum levels of RANTES to be significant
highly increased in patients with AA when compared with controls. The
elevation of serum RANTES levels was positive correlated to the extent
of AA and not related to type of AA . Also, elevated serum RANTES
levels were associated with the presence or absence of atopy that
increased in atopic AA patients. A positive correlation also existed
between RANTES levels and IgE as well as eosinophil percent . No
correlation was demonstrated between RANTES levels and age, sex of
patients, previous episode(s) of AA, Hb concentration, RBCs , platelets
and WBCs counts or other skin or systemic diseases.
Regarding the IgE level there was a significant difference in serum
total IgE in all patients groups of AA when compared to control group
and there was also a significant difference of serum level of IgE with and
without atopy in all patients groups of AA when compared to control
group.
This study revealed also that there was a significant difference in
the eosinophil percent in all patients groups of AA when compared to
control group and there was also a significant difference of eosinophil
percent with and without atopy in all patients groups of AA when
compared to control group.