Faculty Collaboration Database

Macular Alopecia: A Single-Center Retrospective Cohort Study to Describe an Underrecognized Pattern of Alopecia. Pediatr Dermatol 2025;42(4):754-759

Date

04/28/2025

Pubmed ID

40289560

DOI

10.1111/pde.15946

Scopus ID

2-s2.0-105003799057 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

BACKGROUND/OBJECTIVES: The prototypical non-scarring alopecia is alopecia areata (AA), which can present in multiple forms on the scalp, including patchy, ophiasis, sisaipho, diffuse, and totalis. Not included within current alopecia classification systems is a variant characterized by macules < 1 cm in diameter. Our objective was to identify and describe this variant of alopecia not previously recognized.

METHODS: We conducted an institutional review board-approved, single-center retrospective chart review of patients presenting with hair loss to a pediatric dermatology clinic. Potential subjects were identified through a search using ICD9 and ICD10 codes for AA, alopecia unspecified, or other non-scarring alopecia from ambulatory dermatology visits from 2/1/2011 to 2/01/2024. After review, 392 patients with a diagnosis other than patchy AA or macular alopecia were excluded.

RESULTS: Of the 471 patients included in this study, 397 patients were categorized as patchy AA and 74 patients as macular alopecia. Compared to those with patchy AA, patients with macular alopecia had a female (57/74, 77%) and Hispanic/Latinx (46/74, 62%) predominance, with a younger median age of onset (5.9 years). Macular alopecia was located mainly near the parietal scalp. Patchy AA was located mainly on the occipital scalp. When follow-up data was available, resolution of hair loss without recurrence occurred in 63% of macular alopecia (median 5.0 months) and 20% of patchy AA patients (median 8.0 months), p < 0.001.

CONCLUSIONS: We propose the term "macular alopecia" for this entity characterized by small macules and spontaneous resolution within months.

Author List

Thapar M, Feng J, Zhang L, Pan AY, Holland KE, Chiu YE

Authors

Yvonne E. Chiu MD Vice Chair, Professor in the Dermatology department at Medical College of Wisconsin
Kristen E. Holland MD Associate Professor in the Dermatology department at Medical College of Wisconsin
Amy Y. Pan PhD Associate Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Age of Onset
Alopecia
Alopecia Areata
Child
Child, Preschool
Female
Humans
Male
Retrospective Studies
Scalp