Receptor site dominance after hair transplantation in alopecia areata

A 32-year-old woman presented with a patchy and ophiasis type of alopecia areata. She reported that at the age of 25 she had undergone plastic surgery for the same hair problem. In the occipital region, partial excision of bald areas and transplantation of punched grafts from unaffected areas of her scalp had been performed, but these grafts completely lost their hair shortly after transplantation. At the age of 30 she had developed, in addition, patchy alopecia areata in other areas of the scalp. The present observation of receptor site dominance of the area affected by alopecia areata suggests that the primary abnormality is situated in the affected tissue, and that the disease is caused by local spreading of a hitherto unknown factor.