Alopecia Areata Incognita: Clinical Characteristics and Use of the Sinclair Shedding Scale

The document discusses a study on Alopecia Areata Incognita (AAI), a form of Alopecia Areata that presents as persistent, diffuse hair shedding without bald patches. The study involved 4 Caucasian female patients, with an average age of 45.3 years, who had been experiencing excess scalp hair shedding for several years. Despite treatment with oral spironolactone and/or low dose minoxidil for over 6 months, the patients reported no improvement. The study utilized the Sinclair Shedding Scale (SSS) to assess hair shedding, with all patients reporting >Grade 6 daily shedding, representing about 750 hairs per day. The study introduced monthly intralesional corticosteroid scalp injections at 5 mg/mL doses across the scalp as a treatment method. After 2 treatment sessions, all patients reported SSS score improvement to the normal range and increased distal hair density. The study concludes that the SSS is useful in diagnosing AAI and tracking the normalization of hair shedding after treatment.