Association of Serum VEGF-A and VCAM-1 Levels With Nailfold Capilleroscopic Alterations in Alopecia Areata

March 24, 2026 updated by: IPEK SAKIR, Istanbul Training and Research Hospital

The goal of this observational study is to learn about microvascular changes and hair follicle activity in patients with alopecia areata. The main questions it aims to answer are:

Do blood levels of markers related to blood vessel formation (VEGF-A) and inflammation (VCAM-1) differ between patients with alopecia areata and healthy individuals?

Is there a link between these blood markers and structural changes in the nailfold capillaries?

How do these markers relate to specific trichoscopic signs of disease activity (such as black dots or exclamation mark hairs) and the overall severity of hair loss (SALT score)?

Researchers will compare patients with alopecia areata (grouped by disease duration: acute <6 months vs. chronic >6 months) to healthy volunteers to see if there is a significant difference in systemic and local vascular indicators.

Participants will:

Undergo a trichoscopic scalp examination to identify markers of disease activity (black dots, yellow dots, exclamation mark hairs) and calculate the SALT score.

Have their nailfolds examined with a digital capillaroscope (50x) to detect microvascular alterations.

Provide a blood sample to measure the levels of VEGF-A and VCAM-1.

Study Overview

Status

Enrolling by invitation

Conditions

Intervention / Treatment

Detailed Description

Alopecia areata (AA) is a common autoimmune form of non-scarring hair loss. Although the exact cause is unknown, it is thought that inflammation and changes in the microvasculature (small blood vessels) play a significant role. This study aims to investigate the systemic and local vascular components of the disease.

The study includes 60 patients diagnosed with alopecia areata and 30 age- and sex-matched healthy volunteers. Patients are categorized into two groups based on disease duration:

Acute Group: Patients with a disease duration of less than 6 months.

Chronic Group: Patients with a disease duration of 6 months or longer.

Methodology and Procedures:

Dermatological and Trichoscopic Examination: All patients undergo a clinical examination using a Dermlite 5 dermatoscope. The severity of hair loss is calculated using the SALT (Severity of Alopecia Tool) score. Trichoscopic markers of disease activity, including black dots, yellow dots, exclamation mark hairs, broken hairs, vellus hairs, and pigtail hairs, are recorded according to Rudnicka's criteria.

Nailfold Capillaroscopy: To evaluate local microvascular alterations, nailfold capillaroscopy is performed using a Dino-Lite digital microscope (50x magnification). Examinations are conducted on the 2nd to 5th fingers of both hands after a 15-minute acclimatization period in a temperature-controlled room (20-23 °C). Morphological changes such as capillary dilatation, tortuosity, hemorrhages, and avascular areas are documented. An "abnormal pattern" is defined as the presence of two or more abnormalities in at least two fingers.

Biochemical Analysis: Venous blood samples are collected from all participants. After centrifugation, serum is separated and stored at -80 °C. Serum levels of Vascular Endothelial Growth Factor A (VEGF-A) and Vascular Cell Adhesion Molecule 1 (VCAM-1) are measured using the ELISA method.

The study will analyze the correlation between these biochemical markers, trichoscopic activity signs, and capillaroscopic findings to better understand the vascular pathogenesis of alopecia areata across different disease stages.

Study Type

Observational

Enrollment (Estimated)

90

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
      • Istanbul, Turkey (Türkiye)
        • Istanbul Education and Research Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

The study population consists of patients diagnosed with Alopecia Areata (AA) and healthy volunteers recruited from Istanbul Education and Research Hospital, a tertiary care dermatology outpatient clinic in Istanbul. The patient group is stratified into acute and chronic phenotypes based on disease duration. The healthy control group includes age- and sex-matched individuals with no history of hair, nail, or systemic vascular diseases.

Description

Inclusion Criteria:

  • Age: Participants aged between 18 and 60 years.
  • Diagnosis: Clinical and trichoscopic diagnosis of Alopecia Areata (AA) by a dermatologist.
  • Categorization: "Acute" (<6 months duration) or "Chronic" (≥6 months duration) groups.
  • Consent: Ability to provide written informed consent for participation in the study.

Exclusion Criteria:

  • Medical History: Patients with a history of diabetes mellitus, autoimmune diseases, connective tissue diseases, chronic inflammatory or vascular diseases.
  • Pregnancy & Lactation: Pregnancy or breastfeeding.
  • Lifestyle Factors: Active smoking or chronic alcohol use.
  • Hair & Nail Conditions: Causes of hair loss other than alopecia areata, the presence of any nail disease, or having had a manicure within the last 3 weeks.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Acute alopecia areata patients
Patients diagnosed with alopecia areata who have a disease duration of less than 6 months.
Diagnostic test: Microvascular Imaging
his intervention focuses on the integration of microvascular and biochemical markers to phenotype Alopecia Areata subgroups.
Other Names:
  • Nailfold Capillaroscopy
  • NVC
Diagnostic test: Biochemical Biomarker Analysis
Collection of 5-10 mL venous blood samples. Serum is separated by centrifugation (3000 RPM, 10 min) and analyzed via Enzyme-Linked Immunosorbent Assay (ELISA) to determine the levels of Vascular Endothelial Growth Factor A and Vascular Cell Adhesion Molecule 1.
Other Names:
  • Serum VEGF-A
  • Serum VCAM-1
Diagnostic test: Trichoscopic Imaging
his non-invasive procedure focuses on identifying specific trichoscopic patterns associated with Alopecia Areata activity, including yellow dots, black dots, exclamation mark hairs, and broken hairs.
Other Names:
  • Trichoscopy
  • Dermoscopy
Chronic alopecia areata patients
Patients diagnosed with alopecia areata who have a disease duration of 6 months or longer.
Diagnostic test: Microvascular Imaging
his intervention focuses on the integration of microvascular and biochemical markers to phenotype Alopecia Areata subgroups.
Other Names:
  • Nailfold Capillaroscopy
  • NVC
Diagnostic test: Biochemical Biomarker Analysis
Collection of 5-10 mL venous blood samples. Serum is separated by centrifugation (3000 RPM, 10 min) and analyzed via Enzyme-Linked Immunosorbent Assay (ELISA) to determine the levels of Vascular Endothelial Growth Factor A and Vascular Cell Adhesion Molecule 1.
Other Names:
  • Serum VEGF-A
  • Serum VCAM-1
Diagnostic test: Trichoscopic Imaging
his non-invasive procedure focuses on identifying specific trichoscopic patterns associated with Alopecia Areata activity, including yellow dots, black dots, exclamation mark hairs, and broken hairs.
Other Names:
  • Trichoscopy
  • Dermoscopy
Healthy Control Group
Age- and sex-matched healthy volunteers with no history of alopecia, other autoimmune disorders, or systemic inflammatory diseases.
Diagnostic test: Microvascular Imaging
his intervention focuses on the integration of microvascular and biochemical markers to phenotype Alopecia Areata subgroups.
Other Names:
  • Nailfold Capillaroscopy
  • NVC
Diagnostic test: Biochemical Biomarker Analysis
Collection of 5-10 mL venous blood samples. Serum is separated by centrifugation (3000 RPM, 10 min) and analyzed via Enzyme-Linked Immunosorbent Assay (ELISA) to determine the levels of Vascular Endothelial Growth Factor A and Vascular Cell Adhesion Molecule 1.
Other Names:
  • Serum VEGF-A
  • Serum VCAM-1

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Serum Levels of VEGF-A and VCAM-1
Time Frame: At enrollment (Baseline - Single time point)
Serum concentrations of Vascular Endothelial Growth Factor A and Vascular Cell Adhesion Molecule 1 will be measured to evaluate systemic vascular involvement and endothelial activation in patients with Alopecia Areata.
At enrollment (Baseline - Single time point)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Nailfold Capillaroscopic Patterns
Time Frame: At enrollment
Assessment of microvascular morphology (dilatation, tortuosity, hemorrhages) using a 50x digital microscope.
At enrollment
Correlation with SALT Score and Trichoscopic Signs
Time Frame: At enrollment
Evaluation of the relationship between serum biomarkers (VEGF-A, VCAM-1) and clinical severity (SALT score) or activity signs (exclamation mark hairs, black dots).
At enrollment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul Training and Research Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

April 1, 2026

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

July 1, 2026

Study Registration Dates

First Submitted

March 24, 2026

First Submitted That Met QC Criteria

March 24, 2026

First Posted (Actual)

March 30, 2026

Study Record Updates

Last Update Posted (Actual)

March 30, 2026

Last Update Submitted That Met QC Criteria

March 24, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • E-10840098-202.3.02-7702

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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