The article describes two cases of men with diffuse patternless alopecia (DUPA), characterized by extensive hair thinning including the back of the head (occipital region). A paired examination of the top of the head and the occipital region also revealed involvement of the potential donor area for hair transplantation. Trichoscopy and biopsies confirmed miniaturization of hair follicles in both areas. Patients were treated with finasteride and minoxidil, which resulted in improved hair density and reduced miniaturization after 6 months. The study emphasizes the importance of a thorough examination of the occipital region in the diagnosis of DUPA. Paired trichoscopic and biopsy examination can help in correct diagnosis and setting of treatment. Missing donor site involvement may lead to inappropriate surgical advice.