الفهرس 
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Abstract
SUMMARY & CONCLUSION
Alopecia areata is an autoimmune form of non-scarring hair loss that may affect any hair bearing area. The prevalence of the disease is 0.2% in the general population with a lifetime risk estimated at 1.7–2.1%
Based on the extent of hair loss, alopecia areata is classified as: patchy alopecia areata with partial scalp hair loss, alopecia areata totalis with complete scalp hair loss, and alopecia areata universalis with complete scalp and body hair loss.
Clinically, various patterns of hair loss may be observed: patchy, ophiasis (band like hair loss in the parieto temporo occipital area), ophiasis inversus sisaipho (band like hair loss in the fronto parieto temporal area), reticulate and diffuse. The diagnosis of alopecia areata is commonly established based on clinical appearance.
Alopecia areata is a tissue restricted autoimmune disease that occurs mostly in genetically predisposed individuals. It is triggered by several factors. These factors include patients’ genetic constitution, immune factors, and oxidative and emotional stress.
Tumor necrosis factor-α is synthesized and released by immune and non-immune cells, stimulating intracellular production of mitochondrial reactive oxygen species. Evidence provides support to the fact that oxidative stress and apoptosis are closely linked physiological phenomena, showing that hair follicle apoptosis is related to oxidants and antioxidants in Alopecia areata. Therefore oxidative stress is one of the possible hypotheses involved in the pathogenesis of Alopecia areata.
Selenium is an essential trace element important in the synthesis of selenoproteins as well as glutathione peroxidase and thioredox in with antioxidant properties essential in the body’s defense mechanisms. It has also an immunomodulatory effect, mainly by stimulating the high-affinity interleukin 2 receptor on activated T lymphocytes and natural killer cells, leading to their clonal expansion and differentiation into cytotoxic T lymphocytes. Selenium also prevents oxidative stress -induced damage to immune cells.
The aim of the present study was to evaluate serum level of selenium in patients with alopecia areata and to assess its clinical significance,
The current study was a case control study. All patients were selected from the outpatient clinic of Dermatology and Andrology Department of Beni Suef University Hospital. This study was performed over duration of six months. This study included 50 patients suffering from alopecia areata group (group A). In addition, 50 apparently healthy individuals of matched age and sex were chosen as a control group (group B). Estimation of serum level of selenium was compared in both patients with alopecia areata group and control group.
The main results of the study revealed that:
The mean age of cases of alopecia areata (group A) was 18.21 years, whereas the mean age of the control group (group B) was 27.36 years,. There was no significant difference in age between both groups.
Regarding sex, nineteen cases were males (38.0%) and thirty-one cases were females (62.0%), while twenty-three of the control group were males (46.0%) and twenty-seven were females (54.0%), with non-statistically significant difference between both groups
The course of the disease was progressive in forty-five patients (90.0%) and stable in five patients of alopecia areata patients (10.0%)
Regarding family history, two cases (4.0%) had positive family history and forty-eight cases (96.0%) had negative family history. While no one of the control group had positive family history (0.0%). There was no statistically significant difference between both group
Median serum level of selenium in control group was 125.0 ng/ml, minimum level was 84.10 ng/ml, and maximum level was 161.60 ng/ml. Selenium level had statistically significant lower level in alopecia areata group than the control group.
There was no significant difference between cases and control as regard Hb level, WBCs number, Platelets number, TSH level, presence or absence of autoantibodies.
There is no significant correlation between selenium level and age.
There is significant positive correlation between selenium level and SALT score.
There is high significant positive correlation between selenium level and progressive Course of disease
There is no significant correlation between selenium level and Stable Course of disease.
Based on our findings, we recommend for oral supplementation of selenium for alopecia areata patients.
In conclusion: Alopecia areata is a disease of unknown etiology and multiple co-factors, attention should be paid for the role of trace elements in the pathogenesis of that disease. According to previous results, lower serum Se levels were found in association with AA Egyptian patients, which might be caused by the increased demand for antioxidants to combat the OST and inflammatory process in AA.