Snapshot A 35-year old woman with a past medical history of atopic dermatitis comes to the dermatologist for multiple, round patches of balding on her scalp. She has had more and more of these bald spots for about 2 months. She cannot recall any instigating events and denies pulling out her hair intentionally. Physical exam reveals no inflammation or erythema in the affected areas. A punch biopsy reveals lymphocytic infiltration. She has a family history of rheumatoid arthritis and Grave’s disease. Introduction Chronic, autoimmune non-scarring hair loss disorder login to view 1 more bullet Epidemiology: login to view 3 more bullets Associated conditions: login to view 1 more bullet Presentation Symptoms: login to view 4 more bullets Evaluation Clinical evaluation of hair loss sites login to view 4 more bullets Punch biopsy login to view 1 more bullet Laboratory studies normal Differential Diagnosis Tinea capitis Trichotillomania (nervous hair pulling) Androgenetic alopecia login to view 1 more bullet Cicatricial alopecia Telogen effluvium Traction alopecia login to view 1 more bullet Treatment Watchful waiting for mild cases, as hair may regrow spontaneously Limited therapies available; all with limited efficacy login to view 4 more bullets Currently under investigation: targeted immunotherapies login to view 1 more bullet Prognosis, Prevention, and Complications Variable, unpredictable pattern of regrowth, patchy hair loss, and progression to alopecia totalis or universalis