Mirror-Image Alopecia Areata in Mirror-Image Twins

This article reports the first documented case of mirror-image alopecia areata (AA) in mirror-image identical twin sisters, aged 6, who presented with patchy hair loss on opposite sides of their occipital scalps. The twins, born from a non-consanguineous marriage, showed no family history of AA, and genetic testing for monozygosity was not conducted due to financial constraints. Dermoscopy revealed typical AA features, and treatment involved topical mometasone 0.1% lotion. The study highlights the complex interplay of genetic and environmental factors in AA, with previous research indicating a 55% concordance rate of AA in monozygotic twins.