Hymenoptera Envenomation as a Potential Trigger for Acute Diffuse Alopecia Areata: A Case Report.

INTRODUCTION

Alopecia areata (AA) is an autoimmune hair loss disorder often triggered by genetic and environmental factors. Acute, massive shedding is unusual and may indicate a potent immune trigger.

CASE PRESENTATION: We report a 34-year-old woman with Hashimoto thyroiditis who developed rapid, diffuse AA 10 days after bee stings. Clinical examination showed marked hair loss (SALT score 30→70) affecting scalp, eyebrows, and eyelashes. Laboratory workup revealed elevated IgE and venom-specific hypersensitivity. Treatment with corticosteroid pulses followed by oral methylprednisolone and methotrexate led to progressive hair regrowth.

CONCLUSION

This case highlights hymenoptera envenomation as a rare trigger of acute AA, emphasizing the importance of environmental history and immune evaluation in sudden-onset autoimmune hair loss.