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Background: Alopecia areata)AA(is a non-scarring skin disease affecting the scalp or other body parts. The etiology of AA is still controversial and various pathogenic causes are under investigations. It is characterized by infiltration of T helper 17 cells the hair follicles and chemokine secretion. Objectives: The aim of the current work was to measure serum level of IL-17A in patients with AA and healthy controls to demonstrate if it has a role in the pathogenesis of A.A. and to correlate disease severity with its level. Patients and methods: This case control study included a total of 26 A.A. patients, and 26 age and gender matched healthy controls, attending at Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Ain-Shams University Hospitals, and Department of Dermatology, Venereology and Andrology, National Research Centre, Egypt. Serum level of interleukin-17 was measured Clinical type, and the severity of the disease were determined for each A.A. patient. Results: Serum level of interleukin-17 was significantly higher in A.A. cases compared to unaffected controls. The interleukin-17 level among A.A. patient was ranged from 133 to 326 (med. 195) pg/ml, while among controls, the level was ranged from 14 to 226 (med. 48) pg/ml. Also, no statistically significant differences were found between interleukin-17 levels regarding the clinical types, age, gender, disease duration, and severity. Conclusion: The significantly high concentration of serum interleukin 17 in A.A. patients supports the theory of its contribution in the process of the hair follicular destruction. It could also be concluded how beneficial its inhibitors can be especially in resistant cases of A.A. [ABSTRACT FROM AUTHOR]

Background: Since frontal hairline is the most characteristic feature of the face for both men and women, affecting the psychological state of patients, hair loss has been considered to be one of the most prominent esthetic problems. Hair loss either resulting from the androgenetic or nonandrogenetic origin is characterized by changes in the anterior line., Aim: The aim of this study was to evaluate the causes of the frontal hairline recession in Egyptian female patients using trichoscopy and to detect the prevalence of each of those causes in Egyptian females., Patients and Methods: This study was performed on a total of 200 Egyptian female patients aged between 15 and 65 years who complained of frontal hairline recession. All patients were derived from Al-Zahraa University hospital outpatient clinic over a period from November 2017 to April 2019. We classified them into two groups according to age: Group A: 15-45 and Group B: 46-65. After full history taking, general and dermatological examination, photographs of hair recession were taken from both frontal and temporal sides. Then, the trichoscopic examination by noncontact dermoscopy was done photographed and evaluated., Results: The most common cause of the frontal hairline recession in Egyptian female patients was androgenetic alopecia (AGA) (50%). Most of the patients were of old age (58%). The high statistically significant trichoscopic findings in androgenetic alopecia were yellow dots, peripilar sign, hair diameter diversity, and single-hair pilosebaceous unit (45.0%, 61.0%, 100.0%, and 96.0%), respectively. On the other hand, perifollicular scaling, absence of hair follicles, and lonely hair revealed a high statistically significant presentation (88.9%, 100.0%, and 22.2%), respectively, with frontal fibrosing alopecia, and vellus hair (100.0%) and perifollicular casts (91.8%) with tractional alopecia. Finally, hair broken at different levels (100%), black powder (88.9%), black dots (100.0%), hook hairs (11.1%), i hair (16.7%),V sign (44.4%), flame hairs (33.3%), coiled hair (5.6%), and burnt match stick sign (5.6%) showed a high statistically significance presentation with trichotillomania., Conclusion: The present study supports the trichoscopic criteria for the diagnosis of causes of frontal hairline recession, which provide a noninvasive diagnostic tool compared with histopathological diagnosis., (© 2020 Wiley Periodicals, Inc.)

A 3500-year-old papyrus from ancient Egypt provides a list of treatments for many diseases including "bite hair loss," most likely alopecia areata (AA). The treatment of AA remained largely unchanged for over 1500 years. In 30 CE, Celsus described AA presenting as scalp alopecia in spots or the "windings of a snake" and suggested treatment with caustic compounds and scarification. The first "modern" description of AA came in 1813, though treatment still largely employed caustic agents. From the mid-19th century onwards, various hypotheses of AA development were put forward including infectious microbes (1843), nerve defects (1858), physical trauma and psychological stress (1881), focal inflammation (1891), diseased teeth (1902), toxins (1912) and endocrine disorders (1913). The 1950s brought new treatment developments with the first use of corticosteroid compounds (1952), and the first suggestion that AA was an autoimmune disease (1958). Research progressively shifted towards identifying hair follicle-specific autoantibodies (1995). The potential role of lymphocytes in AA was made implicit with immunohistological studies (1980s). However, studies confirming their functional role were not published until the development of rodent models (1990s). Genetic studies, particularly genome-wide association studies, have now come to the forefront and open up a new era of AA investigation (2000s). Today, AA research is actively focused on genetics, the microbiome, dietary modulators, the role of atopy, immune cell types in AA pathogenesis, primary antigenic targets, mechanisms by which immune cells influence hair growth, and of course the development of new treatments based on these discoveries., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)