28, Female , Caucasian

patchy hair loss on her scalp, which began approximately 3 months ago. She has noticed round, smooth patches of baldness without hair regrowth in these areas. The hair loss was sudden and progressive. She also reports experiencing increased stress at work and home during this time, though no major trauma or illness occurred. The patches are not associated with pain or itching.

Bald patches , itching, tingling

Well demarcates bald patches

.

multiple round and smooth patches of hair loss on the scalp, cbc normal , thyroid normal , no autoimmune diseases , peribulbar lymphocytic infiltrate, trichoscopy exclamation mark hairs , empty follicles

Tinea capitis , telogen effluvium , traction alopecia lupus

Alopecia areata

Jak inhibitors , minoxidil , intralesional corticosteroids

Topical steroids clobetasol