<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p><italic>Background</italic>: Alopecia Areata (AA) is a disease characterized by hair loss that is widely believed to be autoimmune in origin. Thus treatment is generally aimed in this direction using immune inhibitors such as steroids and PUVA.</p> <p><italic>Objective</italic>: To describe a variant of AA, Pseudo Alopecia Areata, caused by a particular cupola pin holder (tic-tac) and to offer a non-pharmacological treatment option (NPT).</p> <p><italic>Methods</italic>: A prospective open label study in 37 Jewish religious patients (34 males, 3 females, mean 35 ± 2 years), previously diagnosed and treated for scalp AA were randomly referred to one of the three NPT intervention methods: small cupola held by two pins, large cupola held by one pin and similar cupola held by a different pin.</p> <p><italic>Results</italic>: Three of the ten patients (33.3%) from the first group developed secondary AA from the additional pin. No changes were seen in the second group. Ten of the seventeen patients (58.8%) from the third group achieved immediate improvement subsequent to replacing the original pin with a new one on a larger cupola.</p> <p><italic>Conclusions</italic>: Conservative pharmacological treatment failed to repair the lesions. The addition of a second pin caused an additional lesion. In contrast, replacing the cupola with a larger one and the original pin-fastener with a different type, successfully reduced the lesions.</p>
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Clin Dev Immunol. 2003 Jun-Dec; 10(2-4):193-195