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What are the main clinical differences between AAI and DAA?
AAI presents with diffuse hair thinning mostly in the occipital-parietal region and is often associated with androgenetic alopecia (95%). DAA involves parietal and anterior-temporal areas with a more acute onset and less association with androgenetic alopecia (24%).
Which type of alopecia is more common in young women and often misdiagnosed as telogen effluvium?
Alopecia Areata Incognita (AAI), often seen in women aged 20–40, presents with acute, diffuse hair loss and is frequently mistaken for telogen effluvium.
What are the key trichoscopic features of AAI?
Empty yellow dots, yellow dots with vellus hair, small regrowing hairs, and pigtail hairs (pigtail hairs are almost exclusive to AAI).
What trichoscopic signs are more frequent in DAA?
Dystrophic hairs and black dots, indicating more severe inflammatory damage.
What is the most common trichoscopic feature in both AAI and DAA?
Empty yellow dots.
How does histopathology differ between AAI and DAA?
AAI shows preserved follicular units with reduced terminal anagen follicles and many dilated infundibular ostia filled with keratin and sebum. DAA has fewer terminal anagen follicles, more telogen hairs, and more profound lymphocytic infiltrates in the hypodermis.
What histopathological sign is more severe in DAA compared to AAI?
Lymphocytic infiltrate is deeper and more abundant in DAA, indicating acute damage.
What is the treatment of choice for both AAI and DAA?
High-potency topical corticosteroids such as clobetasol 0.05% cream or foam under occlusion.
What was the treatment response after 4 months for AAI and DAA?
AAI: 73.8% improvement, DAA: 68% improvement.
Which trichoscopic sign is considered almost exclusive to AAI?
Pigtail hairs.
What feature helps trichoscopy select the best biopsy site in AA variants?
Presence of yellow dots, regrowing hairs, and black/dystrophic hairs guide optimal biopsy site selection.
What does a positive pull test suggest in both AAI and DAA?
Indicates telogen hairs and more active hair shedding, often correlating with severity and need for treatment.
What percentage of AAI patients also had androgenetic alopecia?
95.3%.
What is the average age and gender distribution of AAI and DAA patients?
AAI: avg. age 40.5, 98% female; DAA: avg. age 38.5, 100% female.
