Sudden Onset Hair Loss and Color Change

In 2013, a 56-year-old man presented with sudden hair thinning and a change in hair color from dark brown to white over the course of a month. He had a history of hypertension treated with atenolol and ramipril. Clinical examination and scalp biopsies showed an increased number of hair follicles in the catagen or telogen phase and a peribulbar lymphocytic infiltrate, leading to a diagnosis of diffuse alopecia areata. Other potential diagnoses such as telogen effluvium, drug-induced hair loss, and underlying medical conditions were considered but deemed less likely. The patient's hair loss was investigated using blood tests and scalp biopsies to exclude other causes. The hair color change was thought to be due to alopecia areata affecting pigmented hairs more than white hairs. Although treatments like topical immunotherapy and corticosteroids are available, the patient experienced spontaneous hair regrowth and repigmentation after six months without any treatment.