A 3-year old female with asymptomatic scalp hair loss

Presenter: Dustin Wilkes
Dermatology Program: St. Joseph Mercy Hospital
Program Director: Dr. Daniel Stewart
Submitted on: Oct 1, 2012

CHIEF COMPLAINT:  A 3-year-old Caucasian female presented with her mother for one-week history of asymptomatic hair loss of the scalp. No family history of alopecia was noted.

PHYSICAL EXAM:

Bilateral, symmetric patchy hair loss of the parietal scalp extending to the occipital scalp. There was a positive hair pull test (>6 hairs), which did not disturb the child. Eyebrow and eyelash hair was full and intact.

Left Parietal Scalp

 

Left Parietal Scalp closeup

LABORATORY TESTS:

DERMATOHISTOPATHOLOGY:

On light microscopy there was a ‘rumpled sock’ appearance of the cuticle near the bulb.

 

Light Microscopy

DIFFERENTIAL DIAGNOSIS:

1.   Loose Anagen Hair Syndrome
2.   Alopecia Areata
3.   Telogen Effluvium
4.   Trichotillomania
5.  


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