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This describes the sudden appearance of a circumscribed totally bald patch, or patches. The diagnosis of this kind of hair loss is characteristic of the following signs.The follicles within the patch are visible. The skin in (Caucasians) is white. It appears very suddenly, sometimes preceded by itching. Around the periphery of the patch there are very short stumps of hair, these are called exclamation hairs and under the microscope show where the shaft of the hair has been weakened by Auto- immune dysfunction. These hairs also show the patch is extending. Regrowth  is  marked by vellus unpigmented hair usually growing from the centre. Areas on the scalp usually involved are: Occipital, ( nape of neck), Auricular (above the ears). Ophiasic (around the margins, recovery in this area is usually slower than auricular and occipital). Its course is extremely unpredictable, and intermittent relapses are common. Regrowth can occur within weeks or sometimes up to a year or so. Associated signs include sudden loss of pigment in a patch on the skin, this can happen anywhere on the body. Nail pitting is a common sign and the Atopic State -(Asthma, Hayfever, and Eczema). Is a common co factor.

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