Thomas More Syndrome

1916), believed that whitening of hair was related to pigment absorbed and carried away by phagocytes he observed in the vicinity of dystrophic hair follicles and called ‘pigmentophages’ [9] . In 1981, Guin et al. [10] reported a lady whose hair turned white over 3 months with hair thinning but no patches of alopecia. Immunofluorescence studies demonstrated immune deposits along the follicular epithelium suggesting an underlying immunological mechanism. Finally, case reports of sudden canities in association with easily plucked hairs, exclamation mark hairs and patchy alopecia typical of alopecia areata [11] , and in coexistence with other presumably autoimmune phenomena, such as vitiligo [12] , support the immune theory. Ultimately, these observations have led some authorities to speculate that the autoimmune target in alopecia areata may even be related to the hair follicle melanin pigment system [13] . McBride and Bergfeld [14] described mosaic hair color changes in two patients with extensive alopecia areata and suggested that these processes may result from localized immunological reactions against hair follicle melanocytes in a mul