Donor Area Acute Effluvium following Follicular Unit Extraction-Trichoscopic Simulator of Alopecia Areata: Series of Four Cases.

Follicular unit extraction (FUE) is a popular hair transplant technique, which involves extraction of follicular grafts from the donor area, usually occipital area of scalp. We have described few cases where non-scarring alopecia patches appeared at donor area similar to that of alopecia areata clinically, after 2-3 weeks of surgery. Even trichoscopically, findings were similar to alopecia areata showing exclamation marks, black dots. However, on histopathology, there were dilated blood vessels, mucin deposition, and only few lymphocytes, which mimic histopathology of healing wound. We hypothesize that compromised blood supply and trauma to the existing hairs after harvesting can lead to post-hair transplant effluvium, which is probably due to anagen effluvium.