Areata alopecia

Diagnosis: Areata alopecia

Case submitted by Humberto Cantu Garza to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Humberto Cantu Garza. Originally posted November 24, 2012.

Treatment

See case discussion.

Differential Diagnosis

• Tinea capitis • Trichotillomania • Traction alopecia • Telogen effluvium • Secondary syphilis (moth-eaten alopecia) • Discoid lupus erythematosus • Androgenetic alopecia

Key Learnings

• Autoimmune disorder targeting the hair follicle bulb — T-cell mediated attack on anagen follicles • "Exclamation mark" hairs at periphery are pathognomonic • Nail pitting occurs in 10-66% of patients (fine, geometric pitting) • Alopecia totalis (complete scalp) and universalis (complete body) are severe variants • Association with other autoimmune diseases — thyroid, vitiligo, atopic dermatitis • Spontaneous regrowth occurs in ~50% within 1 year for limited patches

Tags: areata, alopecia, humberto cantu garza