Serum granulysin levels in patients with alopecia areata in a tertiary care centre in South India: A Case Control study

Anju Liya Thomas, (2020) Serum granulysin levels in patients with alopecia areata in a tertiary care centre in South India: A Case Control study. Masters thesis, Christian Medical College, Vellore.


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BACKGROUND: Alopecia areata (AA) is an autoimmune process that is directed against the hair follicles. At present, identifying some features at dermatoscopy, hair pull test and Severity of Alopecia Tool (SALT) score helps to assess disease severity. The role of granulysin as a biomarker for the activity of cytotoxic T cells and natural killer cells and therefore as a marker for disease severity and prognosis needs to be explored. OBJECTIVE: Our primary objective was to study serum granulysin levels in adult patients with acute and chronic alopecia areata as compared to healthy controls and our secondary objective was to study the correlation of serum granulysin levels with disease severity. MATERIALS AND METHODS: The present study was a prospective, case control study conducted at the dermatology outpatient department of Christian Medical College, Vellore from January 2019 to August 2019. After obtaining informed consent from patients aged above 18 years, we recruited 22 acute AA cases, 24 chronic AA cases and twenty healthy controls. The demographic details, history of the disease, associated comorbidities, treatment details with response to treatment, clinical features, vital signs, dermatoscopic examination findings, SALT score and AAPI score were assessed. The serum granulysin levels were estimated in the acute and chronic AA cases and compared to 20 healthy controls. The mean (SD) was calculated for all the continuous variables and for serum granulysin levels in acute, chronic AA cases and controls. The Spearman rank correlation was done to estimate the correlation between serum granulysin levels, SALT and AAPI scores. RESULTS: The mean age at presentation in the study subjects was 32.24 ± 9.77 years and a 1:1 male to female ratio was noted. The associated comorbidities that were observed were hypothyroidism in 8.7%, anemia in 8.7%, vitiligo in 4.34% of patients and hypertension was seen in only one patient. The most common trichoscopy findings in were black dots, seen in 65.2%, broken hairs in 52.17%, yellow dots in 47.8% and short vellus hairs in 37% of patients. The most common site of involvement other than the scalp was beard area in 28%, followed by body in 19% and eye brows in 17%. The most common extent of presentation was multiple patchy type AA in 80.4% followed by alopecia universalis in 19.6% of patients. There were no patients with alopecia totalis. The mean serum granulysin levels was 0.28 ± 0.13 ng/ml in acute AA, 0.21 ± 0.08 ng /ml in chronic AA and 0.18 ± 0.06 ng/ml in controls. The serum granulysin levels in acute AA were elevated as compared to the controls and it was statistically significant (p-value =0.005) while chronic AA cases did not show any significant elevation. There was a moderate correlation of serum granulysin in acute AA with SALT score in acute AA with r = 0.410 and a p -value of 0.034 and with AAPI score, r = 0.425 and a p - value of 0.027. CONCLUSION: Serum granulysin may be a biomarker in patients presenting with acute disease and it may also be useful as a prognostic marker.

Item Type: Thesis (Masters)
Additional Information: 201830301
Uncontrolled Keywords: Alopecia areata, granulysin.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 05 Feb 2021 15:29
Last Modified: 05 Feb 2021 15:29

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