Systemic Inflammatory Biomarkers in Alopecia Areata: The Role of SII, SIRI, and CRP/Albumin Ratio

Alopecia areata (AA) is an autoimmune disorder, with potential roles of both genetic and environmental factors. Although AA is a specific autoimmune disease targeting hair follicles, its frequent association with other autoimmune diseases supports the notion that the autoinflammation is not confined to the hair follicles but is systemic. Systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and CRP (C-reactive protein) albumin ratio (CAR) are elevated in various diseases and correlate with disease severity.

The aim of this study was to determine SII, SIRI, and CAR levels in alopecia areata patients and investigate their correlation with disease severity.

The data of 118 AA patients and 122 healthy controls were analyzed. Complete blood count (CBC), CRP, and albumin values were noted during clinic visits. CAR, SII, and SIRI were calculated in both groups.

Although median SIRI and CAR levels were higher in the AA group, the difference was not statistically significant (P>0.05). However, median SII was significantly higher in the AA group (P<0.001). AA patients were divided into two groups according to disease severity: mild disease group (MD) and moderate and severe disease (MSD) group. SII, SIRI, and CAR did not differ between the two groups.

In AA patients, SIRI and CAR did not show significant differences compared to the normal population, while SII was significantly higher. SII was not found to be associated with disease severity, suggesting that systemic inflammation may occur even in the mildest cases of the disease.