200 Journal of the College of Physicians and Surgeons Pakistan 2017, Vol. 27 (4): 200-202 INTRODUCTION Alopecia areata (AA) is an autoimmune disease affecting hair follicle causing non-scarring alopecia with incidence of 0.1 - 0.2%. 1 It can affect any hair bearing area; scalp, beard and body hair, causing mainly psychological morbidity. 2 Aetiology is unknown. Genetic and environmental factors are involved in its pathogenesis. There is increased susceptibility in individuals with HLA DQ3, increased concordance in monozygotic twins and positive family history. Histologically, peribulbar lymphocytic infiltrate predominantly composed of TH 1 cells is seen with high CD4 to CD8 ratio. 3 There is 16% increased life time risk of other autoimmune diseases like vitiligo, autoimmune thyroiditis, systemic lupus erythematosus (SLE) and lichen planus in patients with AA. 4 Recently, increased seasonality of autoimmune and diseases was noticed which is attributed to vitamin D deficiency. 5 Vitamin D is a secosteroid hormone involved primarily in maintaining calcium homeostasis and bone health. It is obtained from diet and also synthesized from skin under UV radiation. Its role in immune system regulation has been extensively studied. It has a role in both innate and adaptive immune response. Vitamin D deficiency predispose the patient to infections like influenza and mycoplasma pneumonia and to autoimmune diseases. The immunomodulatory action of Vitamin D is mediated via VDR (vitamin D receptors) present in cytosol and affect cytokine and chemokine production. The vitamin D deficiency causes loss of self tolerance and predispose individual to autoimmune diseases. 6 Vitamin D deficiency was more common in autoimmune skin diseases like psoriatic patients and in vitiligo. 7 Only few studies have been done to find out association of vitamin D deficiency with AA. The aim of present study was to compare the mean of Vitamin D level of alopecia areata patients to age and gender controlled matched healthy controls. METHODOLOGY This case control study was conducted in Dermatology Department of JPMC, from October 2014 to March 2015, after approval from the Ethical Review Committee of the Hospital. Sampling technique was non-probability purposive sampling. All the patients diagnosed of AA by a trained dermatologist meeting inclusion and exclusion criteria were selected for study. Controls were taken from healthy volunteers and patients coming to dermatology department for other disorders like acne, melasma etc. Those patients who have taken systemic steroids, calcium and vitamin D supplementations, bisphosphonates, immunosuppressive agents, received phototherapy during last one year, pregnant and lactating women, have autoimmune disorders, sarcoidosis, ORIGINAL ARTICLE Vitamin D Deficiency in Alopecia Areata Rabia Ghafoor 1 and Muhammad Irfan Anwar 2 ABSTRACT Objective: To compare the mean Vitamin D level in patients with alopecia areata (AA) with age and gender controlled matched healthy controls. Study Design: Case-control study. Place and Duration of Study: Dermatology OPD, JPMC, from October 2014 to March 2015. Methodology: All the patients diagnosed of alopecia areata by a trained dermatologist were selected. Controls were age and gender matched healthy volunteers. Venous blood was drawn and sent to hospital laboratory for 25 (OH) vitamin D by enzyme immunoassay method on chemical analyser. Data was recorded on SPSS version 16. Mann-Whitney test was applied to compare vitamin D levels of cases and controls. P-value <0.05 was taken as significant. Results: There are 30 cases of AA, and 30 age and gender matched controls. The mean age of our study group was 23.77 ±8.86 ng/dL in patients and 24.03 ±8.62 ng/dL in the control group. Fifteen (50%) patients presented between 3-12 months of onset of AA. Median (IQR) vitamin D level of cases was 13.5 (18.6) ng/dL and healthy controls was 22.5 (16.25) (p=0.001). Conclusion: Serum Vitamin D levels were significantly lower in patients with alopecia areata compared to healthy controls. Key Words: Alopecia areata. Vitamin D deficiency. Vitamin D receptor. 1 Department of Dermatology, Jinnah Postgraduate Medical Centre, Karachi. 2 Department of Dermatology, PNS Shifa, Karachi. Correspondence: Dr. Rabia Ghafoor, Assistant Professor, Department of Dermatology, Jinnah Postgraduate Medical Centre, Karachi. E-mail: rabiaghafoordr@gmail.com Received: October 29, 2015; Accepted: April 26, 2017.