Diagnisis of the AA is essentially clinical and there is no routine
investigation like CBC, TSH, or serum B12 and the other autoantibodies
is required.
We should consider self limitation property of AA in this unusual
location of involvement and encourage the use of cosmetic tools to hide
the lesion.Treatment of the AA is straight forward but due to its
unusuall location use of topical treatment is obviously
unacceptable.Systemic approach like pulse therapy with corticosteroid
or cyclosporine if really wanted maybe considerable, but I think
psychiatry consultation help the patient to accept the lesion and use
the cosmetic tools.