Acute diffuse and total alopecia of the female scalp. A new subtype of diffuse alopecia areata that has a favorable prognosis

Dermatology. 2002;205(4):367-73. doi: 10.1159/000066435.

Abstract

Background: Although alopecia areata (AA) usually starts with focal lesions of hair loss and then presents several different clinical forms, AA may begin as diffuse hair loss. We examined 9 female patients who presented with acute, diffuse and total hair loss of the scalp and took a similar clinical course with a favorable prognosis.

Objective: To categorize such cases as a new subgroup of diffuse alopecia.

Methods: We studied 9 patients who showed acute, diffuse and total hair loss of the scalp within 1 month after their first visit to our hospital by comparing their clinical course, laboratory tests and histopathological findings with those of common, patchy AA, alopecia totalis or alopecia universalis.

Results: None of the patients had a background of systemic diseases or telogen effluvium. All the patients were female, and 8 of the 9 cases recovered cosmetically acceptable hair growth within 6 months regardless of steroid administration. The histology of he lesions was indistinguishable from that of AA except for a remarkable eosinophilic infiltrate.

Conclusions: These cases can be categorized as a new subtype of inflammatory noncicatricial alopecia that is characterized by a marked female predominance, tissue eosinophilia and uniquely short clinical course. We suggest to name it 'acute diffuse and total alopecia of the female scalp (ADTAFS)'.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Acute Disease
  • Administration, Oral
  • Administration, Topical
  • Adult
  • Alopecia / diagnosis
  • Alopecia / physiopathology
  • Alopecia Areata / diagnosis*
  • Alopecia Areata / drug therapy*
  • Alopecia Areata / physiopathology
  • Biopsy, Needle
  • Child, Preschool
  • Diagnosis, Differential
  • Eosinophils
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Injections, Intramuscular
  • Male
  • Middle Aged
  • Prednisone / therapeutic use*
  • Sampling Studies
  • Scalp Dermatoses / diagnosis
  • Scalp Dermatoses / drug therapy
  • Scalp Dermatoses / physiopathology
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Prednisone