Mosaic hair color changes in alopecia areata

This paper documents the mosaic hair color changes in two patients with extensive alopecia areata. The authors suggest that these changes are the end result of localized immunologic reactions directed against the melanocyte, resulting in a cytotoxic effect on the melanocytes and altering the hair color. Visually, the change is identified as patchy lightening, occasional depigmentation, and whitening of existing scalp hair. These changes reflect increased activity and progression of alopecia areata.