Alopecia Areata Incognita in Men Masquerading as Androgenetic Alopecia: A Case Series of 29 Patients in a Single Center Experience

This study focuses on alopecia areata incognita (AAI) in men, a condition that can be mistaken for androgenetic alopecia (AGA) due to its diffuse scalp involvement without well-defined patches. The case series involved 29 male patients with a mean age of 23.1, all of whom had underlying AGA. Common trichoscopic features observed were short regrowing hair, yellow dots, and pigtail hair, particularly in the occipital, parietal, and frontal regions. A positive pull test was noted in 24.1% of patients. Histopathological features of AAI in men were similar to those in women. Treatment with ultra-potent topical corticosteroids and minoxidil led to remission within 4-8 months. The study concludes that thorough trichoscopic examination and trichoscopy-guided biopsy are essential for diagnosing AAI in men with diffuse hair loss unresponsive to standard AGA treatments.