Acute diffuse and total alopecia of the female scalp. A new subtype of diffuse alopecia areata that has a favorable prognosis.
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)'.
Sato-Kawamura
Maki
M
Department of Dermatology, Tohoku University School of Medicine, Sendai, Japan.
Aiba
Setsuya
S
Tagami
Hachiro
H
D000208:Acute Disease; D000284:Administration, Oral; D000287:Administration, Topical; D000328:Adult; D000505:Alopecia / Q000175:diagnosis / Q000503:physiopathology; D000506:Alopecia Areata / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D001707:Biopsy, Needle; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004804:Eosinophils; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D012494:Sampling Studies; D012536:Scalp Dermatoses / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D012720:Severity of Illness Index; D016896:Treatment Outcome
D011241:Prednisone