Hair loss occurs in patches that are usually smooth, without inflammation, and sharply angulated. In this case, the loss is nearly complete in a round patch, mimicking alopecia areata.

Note the bizarre shape of the hair loss, the general retention of the frontal hairline, and some short broken hairs.

A sharply angulated pattern of alopecia is a telltale sign of an ‘outside job’. As in alopecia areata, the scalp is not inflamed, not scaling, and there is no evidence of scarring.