Alopecia Areata — SCE Dermatology MCQ
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Correct answer: D — A child with very early onset, alopecia universalis and nail dystrophy
Explanation lettering: E = shown as B · B = shown as C · C = shown as D · D = shown as E
C is correct. Very early onset, extensive totalis/universalis disease, ophiasis and nail dystrophy each predict a more chronic or treatment-resistant course. A recent limited patch with vellus regrowth and no nail disease has a substantially better chance of spontaneous recovery. Follicular openings are preserved in all non-scarring alopecia areata and do not independently imply poor prognosis.
Reference: British Association of Dermatologists living guideline for alopecia areata 2024: https://academic.oup.com/bjd/article/192/2/190/7829170