Reply

The authors addressed confusion regarding the classification of congenital atrichia forms, specifically alopecia universalis congenita (AUC) and atrichia with papular lesions (APL), both linked to mutations in the hairless gene. They emphasized the clinical distinction between AUC and APL, noting that APL is characterized by a diffuse papular rash, unlike AUC. They also discussed the potential for phenotypic heterogeneity due to modifier genes and the importance of understanding these differences to delineate functional domains in the hairless protein. The authors argued against merging these distinct clinical entities and highlighted the need for careful clinical assessment to differentiate between autoimmune alopecia universalis, AUC, and APL.