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Alopecia Areata — SCE Dermatology MCQ

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HardHair DisordersAlopecia AreataSCE Dermatology

A 12-year-old with a single patch of alopecia areata has no symptoms, goitre or atopy. There is no family history of thyroid disease or other autoimmune disorder. Which investigation strategy follows the BAD approach?

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Correct answer: E — Use risk-directed thyroid testing rather than blanket autoimmune screening

Explanation lettering: D = shown as A · E = shown as B · A = shown as D · B = shown as E

B is correct. Typical alopecia areata is a clinical diagnosis, and broad laboratory screening in an asymptomatic child has low yield. Thyroid testing is targeted to symptoms, goitre, relevant family history and recognised clinical risk factors; other tests follow specific clues or diagnostic uncertainty. A blanket ANA, complement and coeliac panel creates incidental findings without improving routine care. Scalp biopsy or fungal investigation is reserved for atypical morphology, scale, scarring or uncertainty. The management discussion should instead address extent, prognosis, treatment preference and psychosocial impact.

Reference: British Association of Dermatologists living guideline for alopecia areata: https://doi.org/10.1093/bjd/ljaf452