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While the major source of glutamine is skeletal muscles 98 , constant breakdown of proteins to sustain its increased demand as a fuel by the body can result in a reduction in lean muscle mass, further heightening the risk and progression of insulin resistance and other metabolic complications 99

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In such cases, it is essential to use the Alopecia Areata Assessment Tool to differentiate AA from other conditions, including trichotillomania, tinea capitis, scarring alopecia (lichen planopilaris, frontal fibrosing alopecia), syphilitic alopecia, telogen effluvium, female‐pattern AGA, and congenital alopecia, in order to accurately diagnose and select appropriate treatment for AA patients