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Acute alopecia totalis.

Hye-Ja Choi¹, Chull-Wan Ihm

¹Department of Dermatology, Chonbuk National University Medical School and Institute for Medical Science, Chonju 561-712, South Korea.

Acta Dermatovenerologica Alpina, Pannonica, Et Adriatica

|July 20, 2006

Summary

Thirteen patients with alopecia areata (AA) experienced rapid, total scalp hair loss, termed acute alopecia totalis. Most patients recovered with methylprednisolone pulse therapy, though some had recurrences.

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Area of Science:

Dermatology
Trichology

Background:

Alopecia areata (AA) can manifest in various forms.
Acute, diffuse hair shedding leading to total scalp denudation is a distinct clinical presentation.

Purpose of the Study:

To define and characterize a specific subgroup of AA patients presenting with acute total hair loss.
To evaluate the efficacy of methylprednisolone pulse therapy in this patient group.

Main Methods:

Retrospective analysis of 13 patients with AA experiencing rapid, diffuse hair shedding.
Clinical observation, trichograms, and histopathology.
Treatment with methylprednisolone pulse therapy and follow-up.

Main Results:

The 13 patients (mean age 26.7 years) developed total scalp hair loss within 2.3 months.
Trichograms revealed dystrophic and telogen roots.
Hair regrowth occurred in 3.2 months, with recovery in 4.8 months.
8 out of 13 patients (61.5%) achieved normal scalp hair without recurrence after an average follow-up of 53 months.
4 patients had cosmetically acceptable recovery with focal recurrences, and 1 experienced a severe relapse.

Conclusions:

The term "acute alopecia totalis" is proposed to describe this specific AA presentation.
Methylprednisolone pulse therapy appears effective for acute alopecia totalis, with a high rate of sustained recovery.
While generally effective, potential for recurrence necessitates continued monitoring.

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