History and exam

Key diagnostic factors

common

hair loss

Patchy hair loss is most common.

Loss of facial and/or body hair (including brows, lashes, or beard) less common.

Diffuse hair loss, complete scalp hair loss (AA totalis), or complete body hair loss (AA universalis) is rare.

nonscarring alopecia

Follicular markings or orifices are retained. Nonscarring alopecias are considered reversible.

exclamation point hairs

Hairs that are more narrow or attenuated at the proximal end (near the skin) and may be blunt or broken at the distal end.

normal underlying skin in bare areas

The underlying skin may be normal in appearance.

uncommon

nail pitting

Seen in 10% to 66% of patients with AA.[8][Figure caption and citation for the preceding image starts]: Nail pitting in alopecia areataProvided by Paradi Mirmirani, MD [Citation ends].com.bmj.content.model.Caption@4c3d66d9

Other diagnostic factors

common

autoimmunity

AA is associated with a personal or family history of atopy, thyroid disease, or other autoimmune disorders.[8]

Risk factors

weak

autoimmune disease

AA has been reported to be associated with autoimmune disorders, such as thyroid disease, vitiligo, type 1 diabetes, pernicious anemia, and atopy.[8]

family history of autoimmune disease

Family history of autoimmune disorders is increased in patients with AA.[16]

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