Asymptomatic hair loss at...

A 25-year-old male presented to the clinic with complaints of asymptomatic hair loss at multiple sites over the scalp for two months. Hair loss was annular in pattern as it was more evident at the periphery than the patch's centre. There was no history of similar illness in family members and 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 × 4 cm present mainly at the occipital and parietal region of the scalp, as shown in the figure. The area was smooth with no associated skin changes. 

Systemic examination was within the normal limits. At four weeks, potassium hydroxide examination and fungal culture with Sabouraud's media revealed no growth. Histopathological examination showed a few vellus follicles in the mid dermis with a sparse perifollicular lymphocytic infiltrate. The dermis and subcutis also showed several follicular stelae representing former follicular papillae. Based on clinical examination and histopathology, the annular Alopecia areata was made.