BackgroundAlopecia areata incognito (AAI) is an under-recognized variant of alopecia areata (AA) that can easily be misdiagnosed as telogen effluvium (TE) or androgenetic alopecia (AGA). Trichoscopy and histopathology studies in AAI are very few, and this disease entity merits wider recognition.ObjectiveThis is a case series of 30 patients of AAI from India, analyzing the clinical, trichoscopic, and histological features.MethodsA total of 30 patients, 19 females and 11 males of mean age 32.3 +/- 10.5 years, diagnosed with AAI from January 2019 to January 2022 were studied retrospectively. Trichoscopy was performed in all 30 cases. Trichoscopy-guided biopsy was done in 15 consenting patients. Transverse sections were studied for hair counts, ratios, and morphological features.ResultsDiffuse hair thinning was noted, with 73% of patients showing predominant involvement of androgen-dependent scalp. Trichoscopy showed multiple yellow dots, short regrowing hair, and empty follicles. Circle hair or pigtail hair was noted in 77% of patients. Discrete black dots and exclamation-mark hair were seen in only six (20%). The most striking feature on histopathology was the presence of nanogen hairs (miniaturized non-anagen, anagen-like, telogen germ units, or indeterminate hairs) with a mean count of 34%, marking a shift toward telogen in mean anagen:telogen ratio of 1.3:1. Dilated infundibula and subtle peribulbar inflammatory infiltrate around miniaturized follicles and fibrous stellae were observed.ConclusionTrichoscopy-histopathology correlation helps to diagnose AAI and differentiate it from TE or AGA. This would help a clinician to provide better outcomes in hair regrowth.
机构:
Istanbul Univ, Fac Med, Dept Pediat Gastroenterol, Istanbul, Turkey
Istanbul Univ, Fac Med, Dept Hepatol, Istanbul, Turkey
Istanbul Univ, Fac Med, Dept Nutr, Istanbul, TurkeyIstanbul Univ, Fac Med, Dept Pediat Gastroenterol, Istanbul, Turkey
Ertekin, Vildan
Tosun, Mahya Sultan
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Ataturk Univ, Fac Med, Erzurum, TurkeyIstanbul Univ, Fac Med, Dept Pediat Gastroenterol, Istanbul, Turkey
Tosun, Mahya Sultan
Erdem, Teoman
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机构:
Sakarya Univ, Fac Med, Dept Dermatol, Sakarya, TurkeyIstanbul Univ, Fac Med, Dept Pediat Gastroenterol, Istanbul, Turkey
机构:
Columbia Univ Coll Phys & Surg, New York, NY 10032 USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Karimkhani, C.
Boyers, L. N.
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Georgetown Univ, Sch Med, Washington, DC USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Boyers, L. N.
Naghavi, M.
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Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Naghavi, M.
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Coffeng, L. E.
Lott, J. P.
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h-index: 0
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Yale Univ, Sch Med, Robert Wood Johnson Fdn Clin Scholars Program, New Haven, CT USA
VA Connecticut Healthcare Syst, West Haven, CT USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Lott, J. P.
Wulf, S.
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h-index: 0
机构:
Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Wulf, S.
Hay, R.
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Kings Coll Hosp NHS Trust, Dept Dermatol, London, EnglandColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Hay, R.
Williams, H. C.
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机构:
Univ Nottingham, Ctr Evidence Based Dermatol, Nottingham NG7 2RD, EnglandColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Williams, H. C.
Weinstock, M. A.
论文数: 0引用数: 0
h-index: 0
机构:
VA Med Ctr Providence, Dermatoepidemiol Unit, Providence, RI USA
Rhode Isl Hosp, Dept Dermatol, Providence, RI USA
Brown Univ, Dept Dermatol, Providence, RI 02912 USA
Brown Univ, Dept Epidemiol, Providence, RI 02912 USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Weinstock, M. A.
Norton, S. A.
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Childrens Natl Med Ctr, Div Dermatol, Washington, DC 20010 USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Norton, S. A.
Armstrong, A. W.
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h-index: 0
机构:
Univ Colorado, Sch Publ Hlth, Dept Dermatol, Aurora, CO 80045 USA
Eastern Colorado Hlth Care Syst, US Dept Vet Affairs, Dermatol Serv, Denver, CO USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Armstrong, A. W.
Dunnick, C. A.
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h-index: 0
机构:
Univ Colorado, Sch Publ Hlth, Dept Dermatol, Aurora, CO 80045 USA
Eastern Colorado Hlth Care Syst, US Dept Vet Affairs, Dermatol Serv, Denver, CO USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Dunnick, C. A.
Norris, D. A.
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h-index: 0
机构:
Univ Colorado, Sch Publ Hlth, Dept Dermatol, Aurora, CO 80045 USA
Eastern Colorado Hlth Care Syst, US Dept Vet Affairs, Dermatol Serv, Denver, CO USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
Norris, D. A.
Dellavalle, R. P.
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h-index: 0
机构:
Univ Colorado, Sch Publ Hlth, Dept Dermatol, Aurora, CO 80045 USA
Univ Colorado, Sch Publ Hlth, Dept Epidemiol, Aurora, CO USA
Eastern Colorado Hlth Care Syst, US Dept Vet Affairs, Dermatol Serv, Denver, CO USAColumbia Univ Coll Phys & Surg, New York, NY 10032 USA
机构:
Hosp Nacl Pediat Prof Dr Juan P Garrahan, Serv Dermatol, Buenos Aires, DF, ArgentinaHosp Nacl Pediat Prof Dr Juan P Garrahan, Serv Dermatol, Buenos Aires, DF, Argentina
Marta Bujan, Maria
Bocian, Marcela
论文数: 0引用数: 0
h-index: 0
机构:
Hosp Nacl Pediat Prof Dr Juan P Garrahan, Serv Dermatol, Buenos Aires, DF, ArgentinaHosp Nacl Pediat Prof Dr Juan P Garrahan, Serv Dermatol, Buenos Aires, DF, Argentina
Bocian, Marcela
Bettina Cervini, Andrea
论文数: 0引用数: 0
h-index: 0
机构:
Hosp Nacl Pediat Prof Dr Juan P Garrahan, Serv Dermatol, Buenos Aires, DF, ArgentinaHosp Nacl Pediat Prof Dr Juan P Garrahan, Serv Dermatol, Buenos Aires, DF, Argentina
Bettina Cervini, Andrea
Martin Pierini, Adrian
论文数: 0引用数: 0
h-index: 0
机构:
Hosp Nacl Pediat Prof Dr Juan P Garrahan, Serv Dermatol, Buenos Aires, DF, ArgentinaHosp Nacl Pediat Prof Dr Juan P Garrahan, Serv Dermatol, Buenos Aires, DF, Argentina
Martin Pierini, Adrian
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