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Alopecia areata/AA is characterized by immune dysregulation in both scalp and blood, but a largescale approach establishing biomarkers of AA incorporating both scalp tissue and serum compartments is lacking. We aimed to characterize the transcriptomic signature of AA lesional and nonlesional scalp compared to healthy scalp and determine its relationship with the blood proteome in the same individuals, with comparative correlations to clinical AA disease severity. We evaluated lesional and nonlesional scalp tissues and serum from patients with moderate-to-severe AA (n= 18) and healthy individuals (n= 8). We assessed 33,118 genes in AA scalp tissue using RNAseq transcriptomic evaluation and 340 inflammatory proteins in serum using OLINK high-throughput proteomics. Univariate/multivariate approaches were used to correlate disease biomarkers with Severity of Alopecia Tool/SALT. 608 inflammatory …