Annular Alopecia Areata: Report of Two Cases
This was a case report of a 25-year-old male patient who presented with the chief complaints of asymptomatic loss of hair at multiple sites over the scalp for 2 month. Hair loss was annular in pattern as it was more obvious at the periphery compared with the center of the patch. There was no history of similar illness in family members and also no history of drug intake and trauma. On examination, there were multiple well-defined annular patches of non-scarring alopecia of size ranging from 2 cm × 3 cm to 4 cm × 4 cm present mainly at parietal and occipital region of scalp []. The area was smooth with no associated skin changes. Systemic examination was within the normal limits. Potassium hydroxide (KOH) examination of hair showed no fungal elements. Fungal culture with Sabouraud's media at 4 weeks revealed no growth. Histopathological examination from the hairless region in scalp showed a few vellus follicles in mid dermis with a sparse perifollicular lymphocytic infiltrate []. The dermis and subcutis also showed several follicular stellae representing former follicular papillae. The total number of follicles was substantially reduced with no terminal follicles. On the basis of clinical examination and histopathology, the diagnosis of annular AA was made. Patient was given intralesional injections of trimacinolone acetonide (5 mg/ml) every 4 weeks and showed remarkable improvement in the lesions after 3 months (3 intralesional injections) of follow-up [].