Acute diffuse and total alopecia: A new subtype of alopecia areata with a favorable prognosis

BackgroundAlopecia areata (AA) appears in several clinical forms, all having different clinical courses and different prognoses. Acute diffuse and total alopecia (ADTA) has been reported to have a short clinical course ranging from acute hair loss to total baldness, followed by rapid recovery.ObjectiveTo determine the clinical course and prognosis of ADTA through precise clinical observations.MethodsThirty Korean patients who showed ADTA of the scalp within an average of 10 weeks after the onset of hair loss were studied.ResultsMost patients were women who were older than 20 years of age. The histopathology of the lesion revealed infiltration of mononuclear cells around the hair follicles and prominent pigment incontinence. The patients experienced hair regrowth within about 6 months, without regard to the method of treatment.LimitationsThe duration of follow-up after remission ranged from 3 to 49 months, with a mean of 24 months.ConclusionsThese cases can be categorized as having “acute diffuse and total alopecia,” a new subtype of AA that is associated with a favorable prognosis and rapid and spontaneous recovery even without treatment.