Alopecia Areata Incognito: An Elusive Disease

Alopecia areata incognito (AAI) is a less recognized form of alopecia areata that is often misdiagnosed as telogen effluvium or androgenetic alopecia. A study of 30 patients from India, with a mean age of 32.3 years, highlighted the clinical, trichoscopic, and histological features of AAI. Trichoscopy revealed diffuse hair thinning, with 73% of patients showing involvement of androgen-dependent scalp, and common findings included yellow dots, short regrowing hair, and empty follicles. Histopathology showed a significant presence of nanogen hairs and a shift in the anagen:telogen ratio to 1.3:1. The study concludes that trichoscopy-histopathology correlation is crucial for accurately diagnosing AAI and distinguishing it from other forms of hair loss, aiding in better treatment outcomes.