Skip to main content

Diffuse Alopecia Areata


Diffuse alopecia areata is a unique type of alopecia areata that involves widespread scalp hair thinning, instead of just the characteristic patches seen in the normal variant of AA [1]. It is a non-scarring alopecia and can be difficult to diagnose in patients. Although the exact pathophysiology of AA is unknown, it is believed that it has an autoimmune mechanism that targets anagen stage follicles, causing disruption of hair fiber growth. The immune system could be attacking hair follicle melanocytes, dermal papilla cells, and keratinocytes, but as of yet this has not been well established. Diffuse AA is often characterized by more intense inflammation and faster progression compared to patchy AA. The inflammatory infiltrate in diffuse AA includes mononuclear cells, eosinophils, CD3+ T cells, and CD8+ T cells [1].


  • Anagen phase
  • Melanocytes
  • Dermal papilla cells
  • Keratinocytes
  • Inflammation
  • Mononuclear cells
  • Eosinophils
  • CD3+ T cells
  • CD8+ T cells
  • Female preponderance
  • T cells
  • Anagen phase
  • Pruritus
  • Scalp dysesthesias
  • Biopsy
  • Follicular edema
  • Cellular necrosis
  • Pigment incontinence
  • Microvesiculation
  • Telogen effluvium
  • Androgenic alopecia
  • Dermoscopy
  • Topical immunotherapy
  • Dinitrochlorobenzene (DNCB)
  • Squaric acid dibutyl ester
  • Diphencyprone (DPCP)
  • Severe dermatitis

This is a preview of subscription content, access via your institution.

Buying options

USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions


  1. Zhao Y, Zhang B, Caulloo S, Chen X, Li Y, Zhang X. Diffuse alopecia areata is associated with intense inflammatory infiltration and CD8+ T cells in hair loss regions and an increase in serum IgE level. Indian J Dermatol Venereol Leprol. 2012;78(6):709.

    CrossRef  PubMed  Google Scholar 

  2. Chartier MB, Hoss DM, Grant-Kels JM. Approach to the adult female patient with diffuse nonscarring alopecia. J Am Acad Dermatol. 2002;47(6):809–18.

    CrossRef  PubMed  Google Scholar 

  3. Seetharam KA. Alopecia areata: An update. Indian J Dermatol Venereol Leprol. 2013;79(5):563–75.

    CrossRef  PubMed  Google Scholar 

  4. Safavi KH, Muller SA, Suman VJ, Moshell AN, Melton LJ 3rd. Incidence of alopecia areata in olmsted county, minnesota, 1975 through 1989. Mayo Clin Proc. 1995;70(7):628.

    CrossRef  CAS  PubMed  Google Scholar 

  5. Orecchia G, Perfetti L. Alopecia areata and topical sensitizers: allergic response is necessary, but irritation is not. Br J Dermatol. 1991;124(5):509.

    CrossRef  CAS  PubMed  Google Scholar 

  6. Wasserman D, Guzman-Sanchez DA, Scott K, McMichael A. Alopecia areata. Int J Dermatol. 2007;46:121–31.

    CrossRef  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and Permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Khan Mohammad Beigi, P. (2018). Diffuse Alopecia Areata. In: Alopecia Areata. Springer, Cham.

Download citation

  • DOI:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72133-0

  • Online ISBN: 978-3-319-72134-7

  • eBook Packages: MedicineMedicine (R0)