Ijaz Ahmed, Sarwat Nasreen, Umer Jehangir, Zarnaz Wahid.
Clinical spectrum of alopecia areata and its association with thyroid dysfunction.
J Pak Assoc Derma Jan ;22(3):207-12.

Objective: To see the clinical spectrum of alopecia areata and its association with thyroid disorders as well as to determine the frequency of antithyroid antibodies in these patients. Patients and methods: Freshly registered cases of alopecia areata fulfilling the selection criteria were enrolled. Selected patients were examined; scrapings were taken for microscopy with KOH to rule out fungal infection in doubtful cases. Severity of the disease was graded as mild, moderate and severe as well as other clinical patterns i.e. alopecia totalis, universalis and ophiasis. All the selected patients were worked up for thyroid profile comprising serum T3, T4 and TSH. Patients with thyroid dysfunction were screened for antithyroid antibodies. Results: 112 patients comprising 67 (60%) females and 45 (40%) males were enrolled. Minimum age of presentation was 8 years, maximum 40 years with mean age being 18.3 years. The patients were studied in age groups ranging 8-15 years, 16-25 years, 26-35 years and above 35. Majority of the patients (73,2%) were below 25 years. Highest number of the patients i.e. 45 (40%) had mild disease (P<0.05), followed by moderate and severe alopecia areata to alopecia totalis, universalis and ophiasis in a descending frequency. 10 (8.9%) patients revealed thyroid dysfunction, comprising 9 (90%) patients with hypothyroidism and 1 (10%) patient having hyperthyroidism (P<0.05). There were 8 (80%) females and 2 (20%) males. All the females (80%) were hypothyroid and had positive antithyroid antibodies. Among the 10 patients with thyroid dysfunction, 3 (30%) had mild alopecia areata, 3 (30%) presented with moderate disease and remaining 4 (40%) had other clinical patterns of alopecia areata. Antithyroid antibodies were seen in only 1 (10%) patient with mild alopecia areata. Conclusion: Alopecia areata is predominantly a disease of young subjects and presents more commonly as mild or moderate disease. Alopecia areata has a significant association with thyroid dysfunction and antithyroid antibodies without any clinical evidence of the associated disease.

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