A 34-year-old man with a history of ulcerative colitis was referred by his primary care physician to the University of Pittsburgh Hair and Nail Clinic for assessment of a patch of hair loss. The patient had neither a history of diabetes mellitus or thyroid disease nor a family history of alopecia or malignant neoplasm.
Physical examination demonstrated an annular, nonscarred patch of alopecia near the vertex of the scalp consistent with patch-type alopecia areata (AA). Visual inspection of the neck revealed slight asymmetry. Palpation of the neck revealed a definitive nodule in the left lobe of the thyroid that moved with swallowing. The patient denied exertional dyspnea, anterior neck pain, or changes in voice. He had no history of radiation exposure to the head or neck.