ORIGINAL ARTICLE Lipid peroxidation/antioxidant activity in patients with alopecia areata NSA Abdel Fattah, †, * AA Ebrahim, ‡ ES El Okda § † Department of Dermatology and Venereology, ‡ Department of Microbiology and Immunology, and § Department of Community Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt *Correspondence: NSA Abdel Fattah. E-mail: nermeensamy2000@yahoo.com Abstract Background Aetiopathogenesis of alopecia areata (AA) is not fully understood and many factors have been assumed. Oxidant ⁄ antioxidant disequilibrium has been proposed with controversies between results. Objectives The aim of this study was to determine lipid peroxidation ⁄ antioxidant activity in patients with AA and to determine its clinical significance. Methods Fifty non-obese patients with AA and 50 age-, gender- and body mass index-matched controls (25 patients with severe grade acne vulgaris representative of an oxidative stress condition and 25 healthy volunteers), were included. Levels of malondialdehyde (MDA), indicator of lipid peroxidation and antioxidant activity of superoxide dismutase (SOD), were spectrophotometrically measured in blood from all subjects and in scalp tissues from 10 patients with AA. Results No significant differences in MDA levels and SOD activity existed between patients with AA and those with acne. However, significantly higher MDA levels and lower SOD activity were found in patients with AA compared with healthy controls. Within patients with AA, lipid peroxidation ⁄ antioxidant parameters showed significant differences with disease duration, pattern and extent of lesions. Significant positive correlations also existed between tissue and blood SOD activity and between tissue and blood MDA levels of the 10 studied patients with AA. Conclusions Increased lipid peroxidation and defective SOD activity exist in patients with AA. Addition of drugs with antioxidative effects seems to be valuable in treatment. Received: 14 February 2010; Accepted: 18 June 2010 Keywords alopecia areata, malondialdehyde, oxidative stress, reactive oxygen species, superoxide dismutase Conflicts of interest None. Funding resources None. Introduction Alopecia areata (AA) is a non-scarring hair loss disease that ranges in severity from patchy loss of scalp hair to loss of all scalp hair (alopecia totalis; AT) or all scalp and body hair (alopecia univer- salis; AU). 1 Exact aetiopathogenesis of AA is not fully understood and many factors including genetic predisposition, autoimmune reactions and emotional stress have been assumed. 1–5 Understand- ing aetiopathogenesis may help preventing treatment failure and finding new treatment modalities. Few studies have recently proposed the role of oxidative stress in AA. 6–8 Oxidative stress is a condition of oxidant ⁄ antioxidant disequilibrium, in which increased reactive oxygen species (ROS) generation overwhelms antioxidant defence mechanisms leading to oxidative damage of cellular molecules. Of these, lipids are the most sensitive in that polyunsaturated fatty acids in cell membrane react with free radicals to form peroxidation products. Malondial- dehyde (MDA) is the end product and best-known indicator of lipid peroxidation. To deal with harmful effects of ROS, a network of antioxidant defence mechanisms exist. Superoxide dismutase (SOD) constitutes an important fraction of antioxidative capacity of living cells that play the central role in defence against oxida- tive stress. It catalyses the dismutation of superoxide anions to ª 2010 The Authors JEADV 2011, 25, 403–408 Journal of the European Academy of Dermatology and Venereology ª 2010 European Academy of Dermatology and Venereology DOI: 10.1111/j.1468-3083.2010.03799.x JEADV