Volume 19, No.1, April 2012 The Gulf Journal of Dermatology and Venereology INTRODUCTION Alopecia areata is a common disorder of unknown etiology which has an estimated prevalence of 1 in 1000 and accounts for 2% of new dermatologi- cal outpatient attendances in Britain and United States and an incidence of 17.2 per 100,000 per year. 1,2 There is no known race, sex, or occupa- tional predilection for the development of alope- cia areata. Alopecia areata can occur at any age with a mean age of onset of 20 years. 3 The clinical behavior of AA is unpredictable and the pathogenesis is not completely clear. Con- cerned etiologic factors include patient’s genetic structure, the atopic state, nonspecifc and organ- specifc immune reactions, and emotional stress. 4 There is mounting evidence that a T-cell-mediated autoimmune response directed at the hair follicles may be responsible for this disease process. 5 The role of genetic factors in alopecia areata is sug- gested by occurrence of familial cases, occurrence ABSTRACT Objective: To assess the clinical features and associations of alopecia areata in Egyptian population. Patients and methods: A cross sectional study was carried out at the dermatology department, Mansoura University Hos- pital, Mansoura, Egypt during the period from January 2007 to January 2008. During the study period all patients present- ing to the dermatology outpatient clinic with a possible diagnosis of alopecia areata were evaluated. Information regarding age of onset, duration, attack numbers, family history was recorded for every patient. Physical examination and investiga- tions were done to assess the extent of hair loss, nail changes and associated diseases when indicated. Results: 234 patients were enrolled during the study period. The total number of new dermatologic cases seen over this period was 7548. The incidence of AA was 3.1%. One hundred and twenty two (122) patients (52.14%) were males and 112 (47.86%) were females. Mean age of onset was 24.3 years (range 3-57 years). Duration of the illness varied from two weeks to 6 years. One hundred and seventy (170) patients (72.65%) presented with frst episode. One hundred and sixty two (162) patients (69.23%) had patchy alopecia, 32 (13.68%) had ophiasis, 22 (9.40%) had reticulate alopecia, 10 (4.27%) had alopecia totalis (AT), and 4 (1.71%) had alopecia universalis (AU). The majority of patients (194 patients) (82.90%) had their frst episode of alopecia areata before the age of 40 years. Of the patients with onset of alopecia areata before the age of 40 years, 38 patients (38/194) (19.58%) presented with extensive alopecia including AT and AU, compared with 2 patients (2/40) (5%) above the age of 40 years; the difference was statistically signifcant (P< 0.05). Nail changes were seen in 53 (22.64%) patients. Personal and family history of atopy was found in 21 (8.97%) patients. There was no signifcant association between a personal history of atopy and the extent of alopecia areata A family history of alopecia areata was recorded in 34 (14.53%) patients. There was no relation between the frequency of occurrence of family members with AA and the severity of the disease. Eight patients had thyroid disease (3.4%), vitiligo in 4 patients (1.7%), and diabetes mellitus in 5 patients (2.13%). No other autoimmune diseases were reported. Conclusion: Similar to that reported in the Western and Asian literature, AA is predominantly a disease of the young, with most of severe forms occurring in frst three decades of life. In contrary, a lower percentage of our patients had associated atopy, and thyroid disease. Larger studies are recommended to further validate our results. ORIGINAL ARTICLE Alopecia areata in Egypt : Clinical features and associations Elshahat Farag Ahmed, MD, Mamdouh Morsy Abdelgawad, MD, Hanan Fathi, MD, Yousef Elbayoumi, MD Department of Dermatology, Mansoura University Hospital, Mansoura, Egypt 29 Correspondence: Dr. Elshahat Farag Ahmed, Department of Dermatology, Mansoura University Hospital, Mansoura, Egypt