الفهرس 
Alopecia Areata
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Abstract
Alopecia areata (AA) is a common form of non-scarring hair loss of scalp and/or body. Genetic predisposition, autoimmunity and environmental factors play a major role in the etiopathogenesis of AA. Patchy AA is the most common form. Atopy and autoimmune thyroiditis are most common associated conditions. The diagnosis of AA is made on clinical grounds and a good physical examination is imperative to distinguish between the differentials. The course of AA is unpredictable.
Peribulbar and intrabulbar lymphocytic inflammatory infiltrate resembling ”swarm of bees” is characteristic on histopathology. Treatment is mainly focused to contain the disease activity. Corticosteroids are the preferred treatments in form of topical, intralesional, or systemic therapy. Camouflage in the form of wigs may be an alternative option in refractory cases.
Granulysin is a cytolytic and proinflammatory molecule expressed by activated human cytotoxic T lymphocytes (CTLs) and natural killer (NK) cells. It is a member of the saposin-like protein (SAPLIP) family of proteins. Together with other cytokines, Granulysin may constitute a proinflammatory loop and may act as an important player in the inflammatory processes in AA. Granulysin can kill human cells targeted by CTLs or NK cells by virtue of its permeabilizing effects on mitochondrial and lysosomal membranes.
Many recent studies have concluded that Granulysin is an important mediator in the pathogenesis of several skin diseases such as folliculitis, leprosy and alopecia areata. Also Granulysin level are decreased in cancer patients. Granulysin is also a useful biomarker in transplantation. Many recent studies have concluded that Granulysin is a key player in the pathogenesis of several autoimmune diseases such as lichen planus and psoriasis vulgaris.
This study included 50 randomly selected alopecia areata cases of different clinical variants and 30 healthy control subjects. Serum levels of Granulysin were detected using an enzyme-linked immunosorbent assay kit.
Statistical analysis revealed a statistically significant increase in the mean serum Granulysin level in patients with AA compared to healthy control subjects which supports the possible role of Granulysin in AA. Also, there is increased serum Granulysin level in more acute cases and in more active disease. Also, in more severe cases there is general increase in serum granulysin level with no statistically significant difference.
We did not observe any significant association between serum Granulysin level and the type, the age of the patient, gender of the patient of AA.