ORIGINAL ARTICLE Audiological abnormalities in patients with alopecia areata H. Ucak, 1, * E. Soylu, 2 S. Ozturk, 3 B. Demir, 3 D. Cicek, 4 I. Erden, 3 A. Akyigit 5 1 Department of Dermatology, Dicle University Faculty of Medicine, Diyarbakir, 2 Department of Otolaryngology, Medipol University Faculty of Medicine, Istanbul, 3 Department of Dermatology, Elazig Education and Research Hospital, 4 Department of Dermatology, Firat University Faculty of Medicine, Elazig, and 5 Department of Otolaryngology, Elazig Education and Research Hospital, Elazig, Turkey *Correspondence: H. Ucak. E-mail: ucak23@mynet.com Abstract Background Audiological abnormalities seen in various autoimmune disorders raises the question of whether such abnormalities also exist in alopecia areata. Objective This study was performed to detect possible audiological abnormalities in Alopecia areata (AA) patients. Methods The study population consisted of 51 patients with AA and 51 healthy controls. Autoscopic and audiometric examinations of both ears were performed in patients and controls. Audiometric examinations were performed using a pure tone audiometer in a silent cabin. Pure tone thresholds were determined for each ear at frequencies of 250–16000 Hz for air conduction. Results Sensorineural hypoacusis was found in 28 patients with AA (54.9%). Six of these 28 patients showed unilateral minimal hearing loss (>30 dB) at high frequencies only (4000–16 000 Hz), while 22 showed bilateral minimal hearing loss (>30 dB) at high frequencies only (4000–16 000 Hz). Hypoacusis was observed in 13 control subjects (25.4%). Sensori- neural hypoacusis was significantly more frequent in AA patients than controls (P = 0.002). Conclusion Follicular melanocytes may be an important target in the autoimmune process of AA and AA may have an effect on hearing function by affecting the melanocytes in the inner ear. Therefore, there may be a relationship between sensorineural hearing loss and the autoimmune disease, AA. Received: 9 April 2013; Accepted: 6 August 2013 Conflicts of interest None declared. Funding sources None declared. Introduction Alopecia areata (AA) frequently occurs in association with other autoimmune disorders. Some studies indicated that 12% of AA patients also have an autoimmune disease. 1 Autoimmune thyroid disorders, psoriasis, pernicious anaemia and vitiligo are frequent autoimmune diseases in patients with AA. 2–4 Other studies suggested that follicular melanocytes may be an impor- tant target in the autoimmune process of AA. 5 The mechanism underlying destruction of melanocytes in the skin may also affect other melanocytic organs. 6 Vitiligo affects all active melanocytes and auditory problems can occur in patients with this condition. 7 Hypoacusis has been reported in 4–37% of patients with vitiligo. 7–12 It is believed that in vitiligo, as with the loss of epidermal melanocytes, melanocytes in the inner ear lose their preventive function, predisposing the inner ear to effects of damaging environmental factors and leading to sensorineural hearing loss. 13 Thus, previous reports regarding vitiligo patients suggest that melanin may play a key role in the establishment and maintenance of the structure and function of the auditory system and may modulate the transduction of audi- tory stimuli by the inner ear. 8 AA may have an effect on hearing function by affecting the melanocytes in the inner ear. So, this study was performed to detect possible audiological abnormalities in AA patients by comparison with healthy controls. Patients and methods A total of 51 AA patients, all of whom had been referred to the Department of Dermatology of Elazig Education and Research Hospital, and 51 healthy control subjects were enrolled in this © 2013 European Academy of Dermatology and Venereology JEADV 2014, 28, 1045–1048 DOI: 10.1111/jdv.12259 JEADV