الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 157 |  |  |
| | | from | 157 | | |
Abstract
Alopecia areata is a common non-scarring hair loss that affects any hair-bearing area, manifested as a sudden loss of hairs without any inflammation or scarring. The hair loss might be seen in a circumscribed area or the whole scalp (alopecia totalis) or whole body (alopecia universalis). The course of disease is not predictable and often associated with periods of hair loss and regrowth.
The study was conducted on 30 patients presenting with patchy alopecia areata of the scalp. Cases were selected from those attending the dermatology outpatient clinic at Al-Minia University Hospital. Written informed consent was taken from all participating patients or their parents.
This work was done to study the clinical and histopathological changes of the hair follicle in AA patients. By analysis of the data collected from patients included in the current study, the majority of patients were between the age of 12-30 years 80% and only 20% of the patients were above 30 years.
The evaluation of history, clinical examination revealed that the alopecia areata presented in 4 patients with positive family history and in 1 patient with diabetes mellitus. In our study 3 patients (10%) had stressful event prior to the onset of AA, two patients (6.7%) had burning sensation at the site of the lesion prior to the onset of the lesion. None of the patients even the 2 cases with extensive disease showed nail changes.
Patients were classified into four main groups according to the duration of the disease and the appearance or regrowth of hair in a previously affected area: Group (I), the duration of the disease is one month or less (acute stage). Group (II), the duration of the disease is more than one month to less than three months (subacute stage). Group (III), the duration of the disease is three monthsor more (chronic stage). Group (IV), hair regrowth is observed (recovery stage).
One Skin biopsy was taken from the active edge of the lesions or from the center of recent regrowth. Four mm punch biopsies were obtained from 30 patients with alopecia areata and 5 healthy controls. To further improve diagnostic yield of our scalp biopsies, we followed the technique of combining vertical and transverse sectioning of the same biopsy. Only 15 specimens of patchy AA and 5 healthy control specimens were bisected longitudinally into 2 halves, one half sectioned vertically and the other half was sectioned serially transverse from the epidermis to the subcutis to study the follicular anatomy at various levels (infundibulum, sebaceous, eccrine and subcutaneous). At least 4 slides (4 cuts on each) were prepared from the vertically sectioned specimens. This technique was just a modification of Elston et al., 1995 technique, who proposed a combining two punch biopsy specimens in the same block, one cut vertically and the other horizontally. Such modification saved the patient from the scar resulting from obtaining 2 biopsies especially in small lesions of AA.