Focal Asymptomatic Hair Loss in an Adolescent: A Case Report
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Diagnosis of hair loss in pediatric patients can be challenging. Temporal triangular alopecia (TTA) is a benign condition characterized by a focal patch of permanent hair loss involving the temporal or frontotemporal scalp regions. It represents a subtype of non-scarring alopecia. It typically manifests in infancy or childhood before the age of 9 as children undergo a transition from immature vellus to mature terminal hair.

A 13-year-old male presented with focal hair loss involving the right frontal hairline. He reported asymptomatic gradually progressive hair loss thought to have occurred several years ago. He denied history of trauma, hair pulling, pruritus, erythema, scaling in the affected area, or previous similar lesions.

Physical examination revealed a sharply defined solitary unilateral triangular-shaped patch of non-scarring alopecia of the right frontotemporal scalp. White and vellus hairs were scattered throughout the patch, a group of hairs lined the anterior border, and a tuft of hair was present along the inferior border.

A diagnosis of TTA was determined based on the patient’s history and physical examination. Differential diagnosis considered included alopecia areata, however the patient’s negative hair pull test and lack of fractured hairs made this etiology much less likely. No therapeutic intervention was required. The patient and family were counseled regarding the diagnosis and poor prognosis for hair regrowth. The patient has remained asymptomatic, and his alopecia has remained stable since his initial presentation.