Fast Five Quiz: Hair Loss (Alopecia)

William James, MD


August 01, 2022

The presentation of alopecia areata is unpredictable. Extreme variations in duration and extent of the disease occur from patient to patient. The presence of smooth, slightly erythematous (peach-colored) or normal-colored alopecic patches is characteristic. The presence of exclamation-point hairs (ie, hairs tapered near proximal end) is pathognomonic but is not always found. A positive result from the pull test at the periphery of a plaque usually indicates that the disease is active and that further hair loss can be expected. Additionally, hair loss on other hair-bearing areas favors the diagnosis. The condition is usually localized when it first appears. Most patients with alopecia areata present with a single patch. No correlation exists between the number of patches at onset and subsequent severity.

Alopecia areata is most often asymptomatic, but some patients experience a burning sensation or pruritus in the affected area. Alopecia areata most often affects the scalp but can affect any hair-bearing area. More than one area can be affected at once. The most common presentation is the appearance of one or many round-to-oval denuded patches. No epidermal changes are associated with the hair loss.

Learn more about the presentation of alopecia areata.


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