Diffuse Alopecia Areata in a Patient with Autoimmune Thyroid Disease: Atypical Presentation and Literature Review

This review article focuses on diffuse alopecia areata, a rare clinical form of alopecia areata characterized by rapid, uniform hair loss without defined patches, making it challenging to differentiate from telogen effluvium and other non-scarring alopecias. The study analyzed 45 eligible studies using the PRISMA methodology to explore the clinical features, pathophysiological mechanisms, and therapeutic approaches of diffuse alopecia areata associated with autoimmune thyroid disease, particularly Hashimoto's thyroiditis. The findings highlight a significant immunological link involving T lymphocytes and autoantibodies. The review identifies common clinical patterns, useful diagnostic biomarkers, and emerging treatments with improved response rates. It concludes that early recognition of this atypical presentation and systematic thyroid function evaluation are crucial for enhancing clinical management and preventing diagnostic delays.