We would argue that no resources were wasted in this case Sir. Firstly the spontaneous resolution/improvement in this patient’s hair loss occurred after investigations were performed. Investigations were performed with a view to guide possible treatment. Were this patient’s symptoms caused, for example, by telogen effluvium, other than correcting reversible causes such as low ferritin we would have had little to offer with respect to treatments. However as the histology was entirely in keeping with alopecia areata we would have been in a position to offer this gentleman several treatments including treatment with diphencyprone acetate, through our dedicated hair clinic in Greater Glasgow and Clyde. Additionally as alopecia areata is often a chronic condition, and rarely with such rapid resolution as in this case, it is helpful to have a clear diagnosis at baseline before embarking on prolonged treatment with immunotherapy or immunosuppression. Further to this the psychological implications of sudden or indeed gradual onset hair loss in individuals are considerable and thus being able to offer a firm diagnosis, treatment options and a guide to prognosis is of great importance to avoid unnecessary psychological harm.
Rapid Response:
Re: Sudden onset hair loss and colour change
We would argue that no resources were wasted in this case Sir. Firstly the spontaneous resolution/improvement in this patient’s hair loss occurred after investigations were performed. Investigations were performed with a view to guide possible treatment. Were this patient’s symptoms caused, for example, by telogen effluvium, other than correcting reversible causes such as low ferritin we would have had little to offer with respect to treatments. However as the histology was entirely in keeping with alopecia areata we would have been in a position to offer this gentleman several treatments including treatment with diphencyprone acetate, through our dedicated hair clinic in Greater Glasgow and Clyde. Additionally as alopecia areata is often a chronic condition, and rarely with such rapid resolution as in this case, it is helpful to have a clear diagnosis at baseline before embarking on prolonged treatment with immunotherapy or immunosuppression. Further to this the psychological implications of sudden or indeed gradual onset hair loss in individuals are considerable and thus being able to offer a firm diagnosis, treatment options and a guide to prognosis is of great importance to avoid unnecessary psychological harm.
Competing interests: No competing interests