الفهرس 
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Abstract
Alopecia areata (AA) is a non-scarring, inflammatory, autoimmune form of hair loss caused by immunological attack on the hair follicle. Patchy alopecia areata affecting the scalp is the most common type. Alopecia areata affects nearly 2% of the general population at some point during their lifetime.
The specific pathophysiology of AA is yet unknown. However, experts believe it is a complex disease including innate immune dysfunction, environmental exposure, genetic predisposition, and changed microbiome.
The term “microbiome” defines the collective genome of all commensal, symbiotic, and pathogenic microbes living in the human body. The healthy intestinal and skin microbiota is an ecological community of trillions of microorganisms containing viruses, bacteria, archaea, and fungi that share human body space. The composition of microbiota in the gut and skin is influenced by many factors such as the stage of life, nutrition, lifestyle, and gender.
The purpose of this work is to study skin microbiome in patients with alopecia areata compared to healthy controls in Egyptian patients.
This study included 50 subjects (25 patients and 25 controls). The patients were recruited from those attending the dermatology outpatient clinic of Ain shams university Hospital in the period between October 2021 - 2022. The procedures were explained to the patients and controls and informed consent was obtained.
Real-time PCR was used to quantify the target bacterial DNA with gene-specific primers and probe targeting Propionibacterium acnes, Staphy¬lococcus epidermidis genes.
AA patients showed no significant difference in Propionibacterium acnes and Staphylococcus epidermidis gene expression or in the ratio between them among the patient’s group and healthy subjects.
There was a statistically significant negative correlation between the relative gene expression of Staphylococcus epidermidis and the SALT score, contrary to the non-significant correlation found with Propionibacterium acnes. This could be attributed to a protective role of Staphylococcus colonizations in the healthy scalp in the hair follicle against the immune reaction of hair loss.
Staphylococcus epidermidis gene expression was not significantly correlated with age or duration of last attack. In contrast, Propionibacterium acnes showed a statistically significant positive correlation with age.
Larger studies are still needed for more precise identification of the microbiome community on the scalp including other bacterial and fungal components in AA subjects.