GP Quiz 4 - Case 1.
A thirty five-year-old man has developed asymptomatic smooth areas of hair loss in the beard area.
What is the diagnosis?
Alopecia areata.
What else should you look for?
Alopecia in other sites (particularly scalp), other autoimmune disorders e.g. thyroid disease.
What further tests are necessary (if any)?
Usually none. If scaling or pustules are present, fungal scrapings and bacterial culture are necessary in case of infection. If there is sign of another autoimmune disorder, the relevant tests are appropriate.
What is the treatment?
No treatment is usually necessary. Intralesional steroid injections should be undertaken with caution because of the risk of atrophy. The prognosis is generally excellent; full remission is achieved spontaneously in 80%.
This quiz was originally published by ADIS International in August 1996