C-Reactive Protein Levels Potential Hematologic Marker of Severity in Alopecia Areata

Bald spot on the scalp of a child due to alopecia areata.
Researchers believe their study to be among the first to show the relationship between the hematologic and inflammatory parameters of alopecia areata and disease severity.

For patients with alopecia areata, C-reactive protein levels can be a hematological marker for inflammation levels of the disease, according to a study published in the Journal of Cosmetic Dermatology.

The aim of this retrospective study was to assess the relationship between hematologic markers, inflammatory parameters, and disease severity in patients with alopecia areata. Data on demographic characteristics, clinical information, and laboratory results were collected for a cohort of patients with alopecia areata of the scalp and a cohort of healthy control individuals.

Alopecia severity was assessed using the Severity of Alopecia Tool score and laboratory data included white blood cell count, platelet count, red cell distribution width, mean platelet volume, neutrophil count, lymphocyte count, plateletcrit, the ratio of neutrophils to lymphocytes, the ratio of platelets to lymphocytes, erythrocyte sedimentation rate, and C‐reactive protein levels.

Of the 105 patients in the alopecia areata cohort, 68.6% were men, mean age was 24.97 years, 93.3% had patch alopecia areata, average disease duration was about 16 months, and 82.9% had a Severity of Alopecia Tool score of 1. Of the 108 participants in the healthy control cohort, 45.4% were men, mean age was 27.45 years. No significant differences were found between the two cohorts for any hematological markers except for C-reactive protein levels and erythrocyte sedimentation rate.

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Compared with controls, the cohort with alopecia areata had significantly higher C-reactive protein levels (0.749 vs 0.297; P =.001). Conversely, the healthy control cohort had a significantly higher erythrocyte sedimentation rate when compared with the cohort with alopecia areata (9.213 vs 5.676; P =.000). Analysis indicated that there was a significant, positive relationship between Severity of Alopecia Tool score and disease duration (r=.487; P =.000).

Study limitations included the retrospective design, the inability to collect all pertinent confounding variables on all study participants, and the relatively small sample size.

The researchers concluded “that the [C-reactive protein] levels of [alopecia areata] patients were significantly raised relative to those of healthy subjects,” and that this hematological marker could be useful in diagnosing alopecia areata.

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İslamoğlu ZGK, Demirbaş A. Evaluation of complete blood cell and inflammatory parameters in patients with alopecia areata: Their association with disease severity [published online Sept. 10, 2019]. J Cosmet Dermatol. doi: 10.1111/jocd.13131