Alopecia Areata Incognito: A Rare Cause of Hair Loss in Children

Alopecia areata incognito (AAI) is a rare cause of diffuse hair loss in children, characterized by acute and severe hair shedding without the typical bald patches seen in classical alopecia areata. This report presents a 14-year-old girl diagnosed with AAI through trichoscopy, which revealed specific hair patterns such as yellow dots and pigtail hairs. Despite low serum ferritin and vitamin D levels, her thyroid and other hormone levels were normal. Treatment with intramuscular triamcinolone acetonide (TA) and oral iron and vitamin D supplements led to complete hair regrowth within a month after the last TA injection, with sustained results over 2 years. The case highlights the effectiveness of non-invasive trichoscopic diagnosis and intramuscular TA treatment for AAI, offering a promising prognosis for pediatric patients.