Ophiasis is a form of alopecia areata. It is relatively rare, but deserves special mention because of its different morphology, localization, and prognosis.
Alopecia areata is one of the earliest known dermatologic entities, having been described in the Papyrus Ebers, which dates back to 1500-2500 B.C.1 The special ophiasitic form was recognized by Celsus,2 and is so named because of the symmetric bands of alopecia above the ears on the lateral aspects of the scalp, resembling a serpent.
It usually begins near the midline of the occiput as an oval plaque of alopecia having the larger axis vertically. Later, secondary plaques form behind the ears and enlarge anterially above and in front of the ears and posterially to fuse with the original plaque.2 The spread of the alopecia is confined to a horizontal, symmetric band which rarely exceeds more than 1 to 3 in. (2.5 to 8