Alopecia areata (AA) is a type of non-scarring, recurrent patchy loss of hair in hair-bearing areas and is mostly of autoimmune origin. Previous studies have suggested that some autoimmune diseases were found to be associated with vitamin D deficiency. The current study was designed to assess the levels of serum 25-hydroxy vitamin D and C-reactive protein in AA, as compared with controls and to further identify the association between vitamin D levels and disease severity in patients with AA. This cross-sectional study included 45 patients with AA and 45 healthy volunteers. Clinical and anthropometric parameters were recorded, according to a pre-designed proforma. Serum 25-hydroxy vitamin D and high-sensitivity C-reactive protein were estimated using ELISA kits. The severity of AA was determined using Severity of Alopecia Tool (SALT) score. We observed a significant rise in systemic inflammation as seen by elevated high-sensitive C-reactive protein levels and lowered 25-hydroxy vitamin D levels in patients with alopecia areata, compared to controls (p = 0.001). The levels of 25-hydroxy vitamin D showed a significant negative correlation with disease severity, while hs-CRP levels showed a significant positive correlation with disease severity (ρ = − 0.714, p = 0.001 and ρ = 0.818, p = 0.001). Our results suggest significant systemic inflammation and vitamin D deficiency in alopecia areata, more so with increasing disease severity. This gains particular importance in the treatment of alopecia areata in future, as supplementing vitamin D to AA patients would result in reducing the disease severity and inducing remission.
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We thank the Indian Council of Medical Research (ICMR), New Delhi, for approving this project as a Short term studentship (STS) [STS ID: 2016-03495] project to the first author. We also thank Dr Revathy G., Senior Resident, Department of Biochemistry, in our Institute for help rendered during the revision of this manuscript.
Conflicts of interest
The authors report no conflict of interest.
Research involving human participants
This research involved human participants and was approved by the Institute Ethics Committee (Human Studies), JIPMER as Project no. JIP/IEC/SC/2016/28/882.
The study protocol complied with the ethical guidelines of the Declaration of Helsinki and the Indian Council of Medical Research Ethical Guidelines for Biomedical Research on Human Participants. Informed consent was obtained from all the subjects, prior to their enrolment in the study.
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Gade, V.K.V., Mony, A., Munisamy, M. et al. An investigation of vitamin D status in alopecia areata. Clin Exp Med 18, 577–584 (2018). https://doi.org/10.1007/s10238-018-0511-8
- SALT score
- Alopecia areata
- 25-hydroxy vitamin D
- High-sensitivity C-reactive protein