discovered. It is unaccompanied by itching or any sign of inflammation, and may have existed for many weeks before cutting of the hair or a casual examination of the scalp brings it to light. In exceptional cases tenderness upon pressure, anaesthesia, hypersemia, oedema, marked pallor or depression of the patch, are symptoms which have been noted, but ordinarily a partial or complete loss of hair is all that can be seen. The original patch sometimes remains single, but usually other patches develop near the original one, and frequently, by increase
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Fig. 2.–Serpiginous form of alopecia areata.
in size and coalescence, denude a considerable portion of the scalp, as is shown in the accompanying plate and in Fig. 2. The irregular area from which the hair has fallen is smooth and soft, and, unlike a patch from which the hair has been epilated or shaven, the mouths of the hair follicles are scarcely perceptible. In some cases the bald patches are numerous, of varying size, and show little tendency to run together. The affection is by no means limited to the scalp, and in severe cases the eyebrows and lashes also suffer. In adults the bearded portion
