A newly identified pattern of nonscarring alopecia, termed macular alopecia, may represent an underrecognized clinical entity, according to findings from a single-center, retrospective chart review. The research was conducted at a pediatric dermatology clinic between February 2011 and February 2024. The results were published in Pediatric Dermatology.
Investigators reviewed 471 cases of hair loss, ultimately categorizing 397 patients as having patchy alopecia areata (AA) and 74 patients as having macular alopecia, defined by lesions less than 1 cm in diameter.
Compared with patients with patchy AA, those with macular alopecia were more likely to be female (77%) and Hispanic/Latinx (62%) and had a younger median age at onset (5.9 years). Macular alopecia lesions were predominantly located on the parietal scalp, whereas patchy AA lesions were more common on the occipital scalp.
Follow-up data revealed that macular alopecia had a significantly higher spontaneous resolution rate without recurrence (63%) compared with patchy AA (20%). The median time to resolution was shorter for macular alopecia (5.0 months) than for patchy AA (8.0 months).
The authors propose the term macular alopecia to distinguish this presentation from other established patterns of AA. This study highlights the importance of recognizing macular alopecia as a distinct clinical pattern with a favorable prognosis.
Source:
Thapar M, et al. Pediatr Dermatol. 2025. doi:10.1111/pde.15946
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