Persistent Hair Loss

A 28-year-old civil engineer returns to the office complaining of persistent hair loss. Initially, the complaint was visible hairlessness. Her physical examination at the time revealed two discrete 2 cm areas of non-scarring alopecia on the occipital scalp, with patent follicular ostia and no erythema. No hair loss was noted anywhere on her body, and she denies scaling, pain or alopecia being pruritus. Her past medical history is normal, but she has a family history of hypothyroidism and diabetes. She received intralesional steroid injections to decrease hair loss. Two months ago, she started noticing that her hair loss was getting worse, and now she is losing hair in the axilla and pubic region too. Her test results showed normal thyroid test results and normal serum testosterone and estrogen levels; however, nail plates with a rough surface and longitudinal ridging were noticed on physical examination. She was advised to take sulfasalazine. Today, she presented with complete hair loss.

Which of the following diagnoses is most likely based on the patient's history and physical examination findings?

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