Segmented Heterochromia With Calibre Change: An Under-Recognized Sign Of Alopecia Areata

June 2025 in “ British Journal of Dermatology ”

Thomas Harries, Matthew Harries

alopecia areata segmented heterochromia hair shedding hair fibre calibre coudability sign inflammatory process hair follicle

TLDR Segmented hair color changes can indicate active alopecia areata.

The article discusses a case of a 37-year-old woman with a history of patchy alopecia areata (AA) who presented with increased hair shedding and changes in hair color. The patient exhibited segmented heterochromia, characterized by lighter bands of color along individual hair shafts, which were associated with decreased hair fibre calibre. This phenomenon, not typically described in conditions like intermittent iron deficiency anemia, was observed in conjunction with AA. The study highlights this as an uncommon variant of the 'coudability' sign, indicating an ongoing low-level inflammatory process affecting the hair follicle. Recognizing this sign can suggest active disease and the need for additional therapy to prevent progression.

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research Twenty Nail Dystrophy with Alopecia Areata in an Atopic Child

April 2019 in “International journal of research in dermatology”

A child with rough nails also had hair loss and allergies.