Alopecia areata: The Daily PANCE Blueprint
A 22-year-old woman with anxiety presents with patchy hair loss on her scalp. The affected areas are smooth and well-defined. You also notice “exclamation mark hairs.” Which of the following is the most likely diagnosis?
A. Telogen effluvium
B. Alopecia areata
C. Tinea capitis
D. Androgenic alopecia
E. Trichotillomania
Answer and topic summary
The answer is B. Alopecia areata
Alopecia is defined by hair loss from any part of the body (but most commonly associated with the scalp). Causes include congenital or acquired (e.g., telogen effluvium, anagen effluvium, traction alopecia, alopecia areata, and androgenetic alopecia). Treatment depends on the type of alopecia, but may include: minoxidil, anti-androgens, surgery, or corticosteroids.
Alopecia areata specifically is characterized by patchy hair loss with smooth, round, well-defined areas. It is an autoimmune disease. A classic finding is “exclamation point” hairs, which are thin at the base and thicker/darker at the distal end. The first-line treatment is intra-lesional corticosteroids. Other options include systemic steroids, JAK inhibitors, and topical immunotherapy.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Dermatology ⇒ ⇒
