Epidemiology of alopecia areata in Baqubah city/Diyala-Iraq

Background : Alopecia areata is a disease scalp and body hair leading to patches of non-scoring alopecia which is heterogeyous ,it is unown as autommutte disease, there is no prevention & hard cure. Objective: To determine the prevalence rate according to sex &age and the causative factors of alopecia areata in Baquba city. Patients and Methods: A cross-sectional study was in Baquba Teaching Hospital dermatological clinic from 1 st of October 2020 to 31 st of March 2022 at Baquabah teaching Hospital /outpatient Dermatology clinic. The study sample (100) patients with different clinical variants of Alopecia Areata, (71) males and (29) females of different age groups. Results: This study shows that high prevalence among males (71%) with age group (21-30) years old with single patchy alopecia areata with past history of recurrence and associated psychological history. (100) cases of AA were diagnosed. (25%). Single lesion of AA was the most common manifestation (68%). Recurrence history of AA Positive in (55%). Personal history of stress was associated with AA in (64 %). The most common site of alopecia areata was in head (55%). Conclusion: It was concluded that, alopecia areata was more common in male, age (21-30) years, most common single lesion, more in head, with psychological stress history.


Introduction
Hair is one of human appearance. Hair length, colour ,style had been used to make statements about sex, religion, and more. Alopecia, or hair loss, is a common and distressing problem, and a lost sense [1]. Alopecia areata is characterized by patches of non-scarring alopecia affecting scalp and body hair that can cause psychological problem. Alopecia is a form of non-scarring hair loss that occurs on hair bearing skin [2]. It affects approximately 0.1% to 0.2% of the world population. Most patients are relatively of young age group [3].

Statistical Analysis
Data was analyzed by using computer, excel and the variables analyzed by number, percentage and proportion.

Results
This study shows that the disease was high among males 71% with age group more than 20 years old with single patchy alopecia areata with past history of recurrence with associated psychological history.One hundred patients were included with different clinical variants of alopecia areata, 71 males and 29 females of different age groups. Table (1) shows that higher prevalence among male (71%) while (29%) among female. The highest age group was (21-30) years (25%) as shown in Table (2). Table (3) shows that the most common clinical type was single lesion of alopecia areata (68%). History of recurrence of Alopecia Areata was (55%) as shown in Table ( 4). Table (5) shows that there was high association of alopecia areata with psychological stress (64%). The most common site of lesions of Alopecia Areata was the head as shown in Table (6).

Discussion
One hundred patients were included with different clinical variants of Alopecia Areata, 71 males and 29 females of different age. Alopecia areata is heterogenous, autoimmun, non-scarring hair loss disorder, or it may affect the entire scalp (alopecia totalis) or the entire body (alopecia universalis) [3]. The course of the disease is unpredictable with, and sudden relapse at any time [12]. In this study the patients included were males (71%) and females (29%) and the study showed high prevelance in male than female. This was in agreement with [12], who performed a study on 43 AA patients; of whom 31 were men and 12 were women. On the other hand was disagree with [7]. Suggested that AA is more common in females than males. other study showed that there is no difference between male and female in distribution of alopecia areata [13]. The age result shows that alopecia areata more common in group age more than 20 years, agree with research [16], and was disagree with research [17]. This study showed an agreement with study conducted in 1991 with high rates of stress (39%) and depression (39%) were reported in a cohort of 31 individuals in the United States [6]. Depression were also observed in a study conducted in Iran, with a high percentage of participants suffering from stress (47%) and depression (56%) respectively [15]. Clinical type shows that single patchy type is most common presentation and that was agree with research [13]. The result of psychological history shows that stress has strong relationship with alopecia areata that agree with the study in Brazil indicated that hair loss was common complaint among women associated with a high prevalence of stress (56%) [19].
Individuals who had hair loss are able to cover the loss with remaining hair and likely to experience psychocology of stress [18]. The study shows that head is most common site and that agree with research by [14][15][16][17][18][19].

Conclusions
It was concluded that, alopecia areata was more common in male, age (21-30) years, single lesion, more in head, with history of psychological stress.

Source of funding:
The current study was funded by our charges with no any other funding sources elsewhere.
Ethical clearance: Ethical approval was obtained from the College of Medicine / University of Diyala ethical committee for this study.