UC Irvine

Background

Alopecia areata (AA) is an autoimmune disease causing hair loss in 2% of the population. Anecdotally, hair specialists report that patches localize to the scalp periphery. Changes in sensory innervation and/or scalp vasculature may play a role in the development and localization of alopecic patches.

Objective

To evaluate the most common locations of initial alopecic scalp patches.

Materials and methods

A retrospective chart review, with comprehensive evaluation of clinical photographs, was conducted from July 2016 to June 2018 to include AA patients (n = 112). Clinical data was collected on gender, age, race, time until presentation at the clinic, and areas of hair loss on initial presentation.

Results

The most common areas of initial AA patches in both females and males were the occiput (49 vs. 48.5%), parietal (46.9 vs. 21.2%), vertex (26.5 vs. 18.2%), and frontal (24.5 vs. 18.2%) regions; 26.8% of patients present with either alopecia totalis or universalis.

Limitations

This is a single-center study with underrepresentation of minority races.

Conclusion

AA patches most commonly present on the occiput of the scalp in both female and male patients. Cervical spine nerves C3 and C2 supply sensory innervation and the occipital artery supplies blood to this area.