Sisaipho Alopecia Areata: An uncommon variant of alopecia areata

What is the “sisaipho” variant of alopecia Areata and how does it differ from the “ophiasis” type?

Alopecia areata is an autoimmune condition that affects about 2 % of the world’s population. Not all patients with alopecia areata have the same appearance to their hair loss. In fact, there are many subtypes of alopecia areata.

See previous article: “The Many Subtypes of Alopecia Areata”

For example, most people develop a single patch of hair loss (called alopecia areata “unilocularis”) or few patches (called alopecia areata “multilocularis"). However other well known forms include alopecia totalis (total loss of scalp hair), universalis (universal loss of all hair on the body), and ophiasis (hair loss along the back and sides of the scalp.

The Sisaipho Variant of Alopecia Areata

If you’ve never heard of the sisaipho variant, it’s for good reason - it is not a common form. In fact, I’ve only had a few patients in my practice who show the classic sisaipho subtype.

The Sisaipho variant of alopecia areata was first described in 1996 by Munoz and Camacho. Among 1604 patients with alopecia areata seen in the Department of Medical-Surgical Dermatology of Virgen Macarena University Hospital, Seville, Spain during an 18 year period, they observed 3 cases of what they called the sisaipho type. 3 cases of 1604 total patients equates to 0.19 %

The word sisaopho is a completely invented word. It is designed to represent the word “ophiasis” spelled backwards. Ophiasis and sisaipho are in many ways “opposites.” Ophiasis alopecia areata is used to describe a type of alopecia areata whereby patients LOSE hair along the sides and back of the scalp. In contrast, sisaipho alopecia areata is used to describe a type of alopecia areata whereby patients KEEP hair along the sides and back of the scalp and lose it in middle and top of the scalp. This is shown in the diagram.

Frequency of Alopecia Areata Subtypes in the Munoz and Camacho 1996 Study

The Munoz and Camacho study of 1996 nicely outlined the frequency of the various types of alopecia areata. The most common types were multilocularis (many patches) and unilocularis (one patch) with over three-quarters of patients have these types. The sisaipho type occurred in 0.19 % which makes it 14 times less common than the ophiasis variant from which its name was derived.

Reference

Munoz and Camacho. Sisaipho: A New Form of Presentation of Alopecia Areata. JAMA Dermatology Oct 1996.