F 67, left scalp, bald patch, biopsy

presentation2

 

Alopecia areata

Microscopic features

  • Epidermis is normal.
  • Dermis shows one hair follicle infiltrated diffusely by lymphocytes (swarm of bees pattern), a characteristic feature of alopecia areata.
  • There is no lichenoid dermatitis, feature of lichen planopilaris or lupus dermatitis.

 Clinical features

  • In alopecia (hair loss) areata, one or more round bald patches appear suddenly, most often on the scalp. Alopecia areata is also called autoimmune alopecia, histologically characterised by infiltration of hair follicles by T lymphocytes.
  • Males and females may develop alopecia areata at any age. It starts in childhood in about 50%, and before the age of 40 years in 80%.
  • There is no cure for alopecia areata, however, spontaneous regrowth is common.

Deba P Sarma, MD., Omaha