Investigate the role of Zinc and Ferritin in Iraqi patients with alopecia areata

Alopecia areata (AA) is an auto-immune disease in which there is an inflammation around the anagen phase of hair follicles. Many nutritional elements were found to modulate this immune response. Zinc and ferritin have many vital roles inside the body and are considered among the most important nutritional factors in immune modulation and division of hair follicle matrix cells. This study aimed to investigate the role of zinc and ferritin in patients with alopecia areata. A case control study including a total of 40 patients with AA who were attending the outpatient clinic at Al-Kindy Teaching Hospital, Baghdad during the period from 2nd June 2019 to 31st March 2020. Other 65 age- and gender- matched apparently healthy subjects. Demographic of the patients and controls and clinical data of the patients were recorded through direct interview. Blood samples were collected from all participants, and serum level of zinc and ferritin were measured using enzyme linked immunosorbent assay(Elisa). Results revealed that in three-fourth of the patients, only scalp was involved in the lesion, while mixed lesion was reported in the 25% of the patients. Single and multiple lesions were reported in 42.5% and 57.5% of the patients respectively. Median serum level of ferritin in patients was 23.0 μg/L (range=3-98 μg/L) which was lower than that of controls (median = 27.0 μg/L, range= 10-166 μg/L) with a significant difference. Likewise, median serum level of zinc was 59.5 μg/dl (range= 15-175 μg/dl) in patients compared with 71.5 μg/dl (range= 21-201 μg/dl) in controls with a significant difference. Zinc level showed a significant positive correlation with age (r= 0.334, p= 0.041) and negative correlation with lesion size (r= -0.327, p= 0.045). In conclusion, multiple lesions in the scalp are the most common presentation of patients with AA. Low levels of ferritin and/or zinc could be involved in the pathogenesis of AA and increase the risk of disease severity.