{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:24:24Z","timestamp":1770337464517,"version":"3.49.0"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,1,24]],"date-time":"2019-01-24T00:00:00Z","timestamp":1548288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Alopecia areata (<jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>) is an autoimmune condition that usually presents as patchy, nonscarring hair loss. Autoimmune disorders and atopy are reported as comorbid conditions. We aimed to investigate the demographics, clinical characteristics, and associations of <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> in Tunisian patients<jats:bold>.<\/jats:bold><\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Demographic data, pattern of alopecia, age of onset, and associations were evaluated in 204 patients from January 2012 to June 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and four cases of <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> were seen. The male to female ratio was 0.68. The mean age at presentation was 23 years old. Positive family history was noticed in 22.1% of patients. Personal history of atopy was associated with <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> in 18.1%. Associated autoimmune diseases were thyroid disorders (12.7%), vitiligo (1.5%), psoriasis (three cases), type 1 diabetes (two cases), autoimmune polyendocrinopathy\u2010candidiasis\u2010ectodermal dystrophy (APECED) syndrome (two cases), lichen sclerosus atrophicus (one case), and pemphigus vulgaris (one case). Patchy <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> was the most common manifestation (49.5%) followed by alopecia universalis (27.5%), alopecia ophiasis (12.7%), and alopecia totalis (10.3%). Nail changes consisting of pitting, trachyonychia, and longitudinal ridging were reported in 24.8%. <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> patterns were more severe in females (<jats:italic>P<\/jats:italic> = 0.049). Severe forms showed more persistent disease duration (<jats:italic>P<\/jats:italic> = 0.005), earlier onset (<jats:italic>P<\/jats:italic> = 0.001), and more recurring episodes (<jats:italic>P<\/jats:italic> = 0.002) and were significantly associated with nail involvement (<jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study aimed to review epidemio\u2010clinical characteristics and comorbid conditions of <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> in Tunisian patients. More severe cases with a pejorative value of early\u2010onset <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>, long disease duration, and nail involvement were seen in our study.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.14381","type":"journal-article","created":{"date-parts":[[2019,1,24]],"date-time":"2019-01-24T23:26:27Z","timestamp":1548372387000},"page":"811-815","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Alopecia areata in Tunisia: epidemio\u2010clinical aspects and comorbid conditions. A prospective study of 204 cases"],"prefix":"10.1111","volume":"58","author":[{"given":"Aycha","family":"Arousse","sequence":"first","affiliation":[{"name":"Dermatology Department Farhat Hached University Hospital Sousse Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lobna","family":"Boussofara","sequence":"additional","affiliation":[{"name":"Dermatology Department Farhat Hached University Hospital Sousse Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8640-7511","authenticated-orcid":false,"given":"Sana","family":"Mokni","sequence":"additional","affiliation":[{"name":"Dermatology Department Farhat Hached University Hospital Sousse Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rima","family":"Gammoudi","sequence":"additional","affiliation":[{"name":"Dermatology Department Farhat Hached University Hospital Sousse 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