Case Report: Paired Vertex-Occipital Assessment Reveals Donor-Area Involvement in Diffuse Unpatterned Alopecia
March 2026
in “
Frontiers in Medicine
”
Studysummary This study reported that two male patients with diffuse unpatterned alopecia exhibited donor-area involvement in both the vertex and occiput, challenging the assumption of occipital stability for hair transplantation, and showed partial improvement following treatment with oral finasteride and topical minoxidil. Our plain-language summary of this paper — not a Tressless recommendation.
This case report discusses two male patients with diffuse unpatterned alopecia (DUPA), a rare form of androgenetic alopecia characterized by diffuse thinning across the scalp, including the occipital region, which is typically considered a stable donor area for hair transplantation. The study used paired vertex-occipital assessments and found donor-area involvement, with increased hair-shaft diameter variability and follicular miniaturization in both regions. After 6 months of treatment with oral finasteride and topical minoxidil, both patients showed increased non-vellus hair density and reduced miniaturization, indicating short-term stabilization and partial improvement. The report emphasizes the importance of verifying occipital sparing to avoid overlooking donor-area involvement, suggesting that paired vertex-occipital trichoscopy and confirmatory biopsies can enhance diagnostic accuracy and guide treatment decisions.
