A woman presents to a dermatologist because she has lost almost all the hair on her body, including scalp hair, eyebrows, eyelashes, armpit and groin hair, and the fine hairs on her body and extremities. She most likely has a variant of which of the following?
Alopecia areata is caused by an autoimmune attack on hair follicles. It has a wide range of clinical severity, with most cases involving a localized patch of hair (which regrows within 1 year in half of the patients). The hair that does regrow may be gray or depigmented. More severe cases can involve the entire scalp (alopecia totalis) or, as in this patient, the entire body surface (alopecia universalis). These more severe cases are less likely to resolve adequately. Treatment of alopecia areata is often unsuccessful, but topical steroids are typically tried. Androgenic alopecia is common male pattern baldness. Chronic cutaneous lupus erythematosus can produce localized baldness. Lichen planopilaris can produce localized baldness. Ref: Landthaler M., Baumler W., Hohenleutner U. (2012). Chapter 239. Lasers and Flashlamps in Dermatology. In K. Wolff (Ed), Fitzpatrick's Dermatology in General Medicine, 8e.
Alopecia areata
Androgenic alopecia
Chronic cutaneous lupus erythematosus
Lichen planopilaris