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Dogru H. Traction alopecia secondary to obsessive-compulsive disorder. Indian J Dermatol Venereol Leprol 2023; 89:592-594. [PMID: 37067149 DOI: 10.25259/ijdvl_302_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/01/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Hicran Dogru
- Department of Child and Adolescent Psychiatry, Atatürk University School of Medicine, Erzurum, Turkey
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2
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Rand MR, Yale K, Kato BS, Kim DJ, Birmingham S, Mesinkovska NA. Commonly Associated Disorders with Complete Scalp Alopecia in Early Childhood: A Review. Int J Trichology 2023; 15:43-49. [PMID: 37701556 PMCID: PMC10495068 DOI: 10.4103/ijt.ijt_70_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/19/2022] [Indexed: 09/14/2023] Open
Abstract
Complete scalp hair loss can be a source of distress for affected children and their families. In addition to infectious and trauma-related causes of hair loss, infants and children may present with total scalp alopecia arising from a range of genetic predispositions. Our objective with this review was to identify the common genetic conditions in children with complete scalp alopecia. The PubMed Database was reviewed for all articles from 1962 to 2019 containing the search terms related to genetic alopecia. The conditions with at least five reported cases in the literature were considered for the inclusion. All clinical trials, retrospective studies, and cases on human subjects and written in English were included. Six genetic conditions related to complete scalp alopecia were included in this review. The most common genetic conditions associated with total scalp hair loss include: alopecia totalis/Alopecia universalis (AU), atrichia with papular lesions, AU congenita, hereditary Vitamin D-resistant rickets type IIA, alopecia with mental retardation, and pure hair and nail ectodermal dysplasia. In children presenting with total scalp hair loss, a myriad of genetic and environmental factors may be the underlying cause. Increased awareness of potential genetic conditions associated with total scalp hair loss may assist in diagnosis, with improved the prognosis for the children.
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Affiliation(s)
- Michaela Rose Rand
- Department of Dermatology, University of California, Irvine, California 92697, USA
| | - Katerina Yale
- Department of Dermatology, University of California, Irvine, California 92697, USA
| | | | - Dong Joo Kim
- Department of Dermatology, University of California, Irvine, California 92697, USA
| | - Suzanne Birmingham
- Department of Dermatology, University of California, Irvine, California 92697, USA
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3
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John JM, Sinclair RD. Systemic minoxidil for hair disorders in pediatric patients: a safety and tolerability review. Int J Dermatol 2023; 62:257-259. [PMID: 35965281 DOI: 10.1111/ijd.16373] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/23/2022] [Accepted: 07/26/2022] [Indexed: 01/20/2023]
Abstract
Topical minoxidil has been used for many years to treat adult alopecia, and there is growing evidence supporting the off-label use of low-dose oral minoxidil (LDOM). However, there is little data on its use in pediatrics, and there are no recommended treatment guidelines. Adverse events are of particular concern in this population. We retrospectively reviewed the medical records of 63 patients aged between 0 and 12 years from a specialist hair clinic who were treated with LDOM or sublingual minoxidil (SM) to evaluate its safety and tolerability. LDOM and SM were generally well-tolerated, with mild hypertrichosis being the most commonly reported adverse event. Further large-scale studies are warranted to determine the efficacy and optimum dosage of systemic minoxidil for alopecia in the pediatric population.
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Affiliation(s)
- Jared M John
- Sinclair Dermatology, East Melbourne, Victoria, Australia
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4
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Saxton AS, Tung P. A Presentation of New-onset Hair Loss in a 7-year-old. Clin Pediatr (Phila) 2023; 62:157-161. [PMID: 35918885 DOI: 10.1177/00099228221115991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
| | - Puneet Tung
- Department of Pediatrics, University of Florida, Gainesville, Florida, USA
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5
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Gomes TF, Soares RO. Pediatric androgenetic alopecia: an updated review. J Dtsch Dermatol Ges 2023; 21:19-25. [PMID: 36688435 DOI: 10.1111/ddg.14940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/23/2022] [Indexed: 01/24/2023]
Abstract
Pediatric androgenetic alopecia is an underrecognized disorder. A clinical evaluation with trichoscopy should be made in children and adolescents with hair loss and/or reduced hair density. Diagnosis is usually clinical, by observation of the hair loss pattern and performance of trichoscopy. In some cases, hyperandrogenism should be excluded. Although there is no approved therapy for androgenetic alopecia in pediatric age, topical minoxidil, oral minoxidil and topical finasteride may be very useful. Hair transplant may be an option for girls in selected cases. This article is a review of the current state of evidence concerning pediatric androgenetic alopecia.
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6
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Gomes TF, Soares RO. Aktuelle Übersicht zur androgenetischen Alopezie bei Kindern und Jugendlichen. J Dtsch Dermatol Ges 2023; 21:19-26. [PMID: 36721944 DOI: 10.1111/ddg.14940_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/23/2022] [Indexed: 02/02/2023]
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7
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Acar Eser N, Serbest Ceylanoglu K, Malkoc Sen E. Unilateral Ciliary Madarosis in a Child After Coronavirus Disease 2019 (COVID-19) Infection. Ophthalmic Plast Reconstr Surg 2023; 39:e1-e3. [PMID: 36269887 PMCID: PMC9809536 DOI: 10.1097/iop.0000000000002295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Coronavirus disease 2019 life-threatening signs have aroused a great deal of attention since the beginning of the pandemic. In the initial stages of the pandemic, the pediatric population was mostly protected, and the symptoms in affected children were mild. Here, the authors present a 7-year-old boy with left upper eyelid ciliary madarosis that developed 9 weeks after coronavirus disease 2019 infection. During comprehensive ophthalmologic examination, no conjunctival injection, chemosis, erythema, or crusts on the eyelids and no other meibomian gland disease findings were detected. Comprehensive laboratory workup was performed to exclude any other possible causes of ciliary madarosis. All laboratory parameters tested within normal limits. In addition to the patient's ocular surface and physical examination findings, laboratory results and the timing of the symptoms as well as spontaneous recovery at follow-up visits led the authors to conclude that telogen effluvium was to cause of the isolated, unilateral ciliary madarosis in this case.
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Affiliation(s)
- Nazan Acar Eser
- Department of Ophthalmology, University of Health Science, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Kubra Serbest Ceylanoglu
- Department of Ophthalmology, University of Health Science, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Emine Malkoc Sen
- Department of Ophthalmology, University of Health Science, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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8
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Thomas M, Ho N, Sibbald C. A Single Centre Retrospective Review of Nutritional Deficiencies Associated With Telogen Effluvium in the Paediatric Population in Canada. J Cutan Med Surg 2022; 26:420-421. [PMID: 35086345 DOI: 10.1177/12034754221074980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Mary Thomas
- 7938 University of Toronto, Toronto, ON, Canada
| | - Nhung Ho
- 7938 University of Toronto, Toronto, ON, Canada.,Section of Dermatology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Cathryn Sibbald
- 7938 University of Toronto, Toronto, ON, Canada.,Section of Dermatology, The Hospital for Sick Children, Toronto, ON, Canada
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9
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Mosca M, Martin K, Hadeler E, Hong J, Brownstone N, Koo J. Review of the diagnosis and management of pediatric psychodermatologic conditions: Part I. Pediatr Dermatol 2022; 39:17-21. [PMID: 34929757 DOI: 10.1111/pde.14888] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/29/2021] [Accepted: 11/21/2021] [Indexed: 12/01/2022]
Abstract
Pediatric psychodermatologic conditions encompass both primary dermatologic conditions with psychiatric comorbidities and primary psychiatric conditions with self-induced dermatologic manifestations. Detection, diagnosis, and management of primary psychiatric conditions with dermatologic manifestations are challenging due to patient-perceived stigma and lack of educational opportunities for dermatology providers. This two-part series highlights the most up-to-date evidence-based data and management techniques of some of the more common dermatoses of primary psychiatric conditions in children. Part I includes trichotillomania, skin-picking disorder, and onychophagia, and part II covers dermatitis artefacta, body dysmorphic disorder, and delusions of parasitosis by proxy, with special considerations for family dynamics.
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Affiliation(s)
- Megan Mosca
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California, USA
| | - Kari Martin
- Department of Dermatology, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Edward Hadeler
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California, USA
| | - Julie Hong
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California, USA
| | - Nicholas Brownstone
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California, USA
| | - John Koo
- Department of Dermatology, Psoriasis and Skin Treatment Center, University of California San Francisco, San Francisco, California, USA
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10
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Villagrasa-Boli P, Monte-Serrano J, Arbues-Espinosa P. [Focal hair loss in a 7-year old infant]. Aten Primaria 2021; 54:102196. [PMID: 34798416 PMCID: PMC8605063 DOI: 10.1016/j.aprim.2021.102196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Pablo Villagrasa-Boli
- Servicio de Dermatología y Venereología, Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, España.
| | - Juan Monte-Serrano
- Servicio de Dermatología y Venereología, Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, España
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11
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Johns HR, Wright TS, Pourciau CY. Acute onset traction-associated ulceration and alopecia. Pediatr Dermatol 2021; 38 Suppl 2:103-105. [PMID: 34339534 DOI: 10.1111/pde.14728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Traction alopecia is a protracted form of hair loss resulting from persistent tension on the hair follicle . We report a case of a 9-year-old African American girl who presented with extensive scalp ulceration and alopecia 11 days after placement of a synthetic hair braid. Over a period of months, with consistent wound care and low-tension hairstyling, most of the hair regrew. We propose that the ulceration and hair loss in this case represents an acute variant of traction alopecia due to pressure-induced ischemia and necrosis.
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Affiliation(s)
- Hannah R Johns
- Department of Dermatology, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Teresa S Wright
- Department of Dermatology, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Crystal Y Pourciau
- Department of Dermatology, The University of Tennessee Health Science Center, Memphis, TN, USA
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12
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Kassem R, Shemesh Y, Nitzan O, Azrad M, Peretz A. Tinea capitis in an immigrant pediatric community; a clinical signs-based treatment approach. BMC Pediatr 2021; 21:363. [PMID: 34445992 PMCID: PMC8390185 DOI: 10.1186/s12887-021-02813-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 07/16/2021] [Indexed: 12/23/2022] Open
Abstract
Background Tinea capitis is a common cutaneous infection of the scalp and hair follicles, typically diagnosed by direct examination and culture. Treatment with oral antifungals is usually withheld until mycology results are available. In Israel, African refugee children demonstrate higher susceptibility to Tinea capitis and generally fail to undergo follow-up evaluations. Methods This study aimed to identify the clinical characteristics and treatment responses of refugee children in Israel with Tinea capitis, in order to formulate a treatment plan for primary care physicians. To this end, demographic, clinical and laboratory data were extracted from the electronic medical records of 76 refugee children presenting with Tinea capitis during 2016–2017. All measured variables and derived parameters are presented using descriptive statistics. The correlation between background clinical and demographic data and Tinea capitis diagnosis was assessed using the chi-squared and Wilcoxon tests. Correlations between demographic/clinical/laboratory characteristics and other types of fungi or other important findings were assessed using a T-test. Results Scaling was the most common clinical finding. Cultures were positive in 64 (84%) and direct examination in 65 (85%) cases, with a positive correlation between the methods in 75% of cases. The most common fungal strain was T. violaceum. Fluconazole treatment failed in 27% of cases. Griseofulvin 50 mg/kg/day was administered to 74 (97%) children, and induced clinical responses. No side effects were reported. Conclusions The key aim of this study was to emphasize the importance of diagnosis and treatment of these immigrant children by their primary pediatric doctor since it takes, an average of 4.3 months until they visit a dermatologist. During this critical time period, the scalp can become severely and permanently damaged, and the infection can become systemic or cause an outbreak within the entire community. In conclusion, we recommend to relate to scaly scalp in high-risk populations as Tinea capitis, and to treat with griseofulvin at a dosage of up to 50 mg/kg/day, starting from the first presentation to the pediatrician.
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Affiliation(s)
- Riad Kassem
- Dermatology Department, Sheba Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yahel Shemesh
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Orna Nitzan
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.,Infectious Disease Unit, Baruch Padeh Medical Center, Poriya, Israel
| | - Maya Azrad
- Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel
| | - Avi Peretz
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel. .,Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Israel.
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Imhof RL, Cantwell HM, Proffer SL, Tolkachjov SN, Torgerson RR, Tollefson MM. The spectrum of pediatric scarring alopecia: A retrospective review of 27 patients seen at Mayo Clinic. Pediatr Dermatol 2021; 38:580-584. [PMID: 33644931 DOI: 10.1111/pde.14543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND/OBJECTIVE There are few studies examining pediatric scarring alopecia. The objective of this study is to characterize the clinicopathologic findings, comorbidities, and treatment outcomes of pediatric patients with scarring alopecia. METHODS Retrospective review of patients under age 18 diagnosed with scarring alopecia at Mayo Clinic from 01/01/1992 through 02/05/2019. RESULTS 27 patients met inclusion criteria with a mean age of 11.2 years and a racial breakdown of 85.2% (23) White, 11.1% (3) Black, and 3.7% (1) Multiracial. Clinical scarring was noted in most (23, 85.2%). Biopsy confirmed the diagnosis in most (24, 88.9%). The most common diagnoses were folliculitis decalvans (6, 22.2%), lichen planopilaris (6, 22.2%), aplasia cutis congenita (4, 14.8%), tinea capitis (4, 14.8%), and morphea (3, 11.1%). Comorbid depression (6, 22.2%) and anxiety (6, 22.2%) were prevalent. Of the patients who received follow-up, most who pursued treatment achieved stabilization (55.5%) or slowing of progression (27.8%), with 44.4% of those treated experiencing regrowth. Mean time to stabilization in the treated population was 19.6 months. Two patients did not pursue treatment, but received follow-up and these untreated patients did not experience hair regrowth. CONCLUSIONS Most patients presented with clinically evident primary scarring alopecia. Biopsy may confirm the diagnosis. Active treatment should be pursued, and successful treatment often requires combination therapies. Time to stabilization often takes years. Screening for depression and anxiety should be pursued.
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Affiliation(s)
- Reese L Imhof
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA
| | | | - Sydney L Proffer
- Department of Internal Medicine, The Christ Hospital, Cincinnati, OH, USA
| | | | | | - Megha M Tollefson
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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14
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Affiliation(s)
| | - Dawn Marie R Davis
- Department of Dermatology and.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Megha M Tollefson
- Department of Dermatology and.,Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
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15
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Putti CMC, Bortolotti RS, Brito IS, Monteiro Silva R, Ribeiro CSDC. Alopecia difusa infantil causada por Serratia marcences. REVISTA CIÊNCIAS EM SAÚDE 2020. [DOI: 10.21876/rcshci.v10i3.1007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Alopecia infantil é uma doença rara, com uma ocorrência estimada em 1% das consultas dermatológicas pediátricas. Infecções cutâneas, oculares e do mesmo tecido por Serratia marcescens raramente são relatadas. Relata-se um caso de uma paciente do sexo feminino, 2 anos e 3 meses de idade, com quadro de lesões dolorosas em região biparietal do couro cabeludo há dois meses, de aspecto exulcerado, crostoso, associado a secreção serossanguinolenta, purulenta e com alopecia. Inicialmente tratada com antifúngico e antibioticoterapia empírica, sistêmica e tópica, pela hipótese de Kerion Celsi, sem melhora. Foi observado o crescimento isolado da bactéria Serratia marcescens, estabelecendo assim diagnóstico de alopecia por etiologia bacteriana, sendo iniciado tratamento com sulfametoxazol/trimetropin (30 + 6 mg/kg/dia) por 10 dias, com resolução do quadro infeccioso e início da repilação em área de alopecia, restando apenas pequenas áreas cicatriciais como sequela.
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Mahajan R, Daroach M, De D, Handa S. Clinico-dermoscopic features and treatment responsiveness in pediatric alopecia – Experience from a tertiary care pediatric dermatology clinic. Indian J Dermatol 2020; 65:483-488. [PMID: 33487703 PMCID: PMC7810076 DOI: 10.4103/ijd.ijd_121_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Data on clinical and epidemiologic profile on pediatric alopecia is relatively scarce. Aims and Objectives: We aimed to study the clinical, epidemiological, and dermoscopic profile of children presenting with alopecia, and assess the responsiveness to different treatment modalities in a real-life setting. Materials and Methods: This cohort study involved analyzing children presenting with hair loss during the study period. After a detailed history, clinical, and trichoscopic examination, treatment offered to patients and follow-up response to treatment along with relapse of symptoms were noted. Results: Around 119 children were included. Nearly 90% were of acquired etiology. The most common cause of alopecia was alopecia areata (AA) in 85 (71%) patients followed by tinea capitis 9 (7.5%), lichen planopilaris 4 (3.3%), and other less common causes. In patients of AA, dermoscopy showed the presence of black dots in 68% cases, exclamation mark hair in 54% of patients followed by off-white dots, yellow dots, and vellus hair. Patients with an acute course and black dots on dermoscopy responded better to treatment. Relapse was common in patients with early age of onset and longer disease duration. Conclusions: Hair loss is frequently seen in pediatric dermatology clinics. Dermoscopy of pediatric AA shows scarce yellow dots while off-white dots are more frequent; the presence of black dots is a good prognostic indicator.
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Brar BK, Brar SK, Kaur R, Sethi N. Hair and Scalp Disorders in Children below 2 Years: An Unremarked Sphere. Int J Trichology 2019; 11:207-212. [PMID: 31728103 PMCID: PMC6830032 DOI: 10.4103/ijt.ijt_77_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Context: Hairs contribute significantly to our appearance and are mirror to many systemic diseases. Hair and scalp disorders in children are associated with profound psychological effects arising from concerns of chronicity, severity, and contagiousness, in addition to cosmetic outline. Studies have documented children below 2 years as the most common age group affected by hair and scalp disorders in the pediatric population; however, to the best of our knowledge, none has been carried out exclusively on this age group, so far. Aims: To determine the pattern of hair and scalp disorders and their underlying etiologies in children below 2 years. Settings and Design: Observational and analytical. Subjects and Methods: Fifty consecutive patients, aged 0–24 months presenting with complaints of hair and scalp disorder, to the outpatient department of dermatology of a tertiary care hospital in North India, constituted the study population. Results: The most common disorder was seborrheic dermatitis (SD) 56%, followed by transient neonatal hair loss 22%. We also came across interesting cases of plica neuropathica (PN) 4%, trichotillomania 2%, and traction alopecia 6%, apart from a list of other disorders noted. The most common age group was 0–6 months. Conclusions: Hair and scalp disorders vary greatly with different demographic areas. In this region of the world, we came across cases of PN due to religious practices. SD was the most prevalent disorder as seen elsewhere. Trichotillomania noted in such a young child was not as a mere habit (as popularly believed), rather an act of anger. Hence, with this study, we want to emphasize the role of detailed history and examination, besides outlining the spectrum of disorders in this age group.
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Affiliation(s)
| | - Sukhmani Kaur Brar
- Department of Dermatology, Adesh Institute of Medical Science and Research, Bathinda, Punjab, India
| | - Rajvir Kaur
- Department of Dermatology, GGS Medical College, Faridkot, Punjab, India
| | - Naveen Sethi
- Department of Dermatology, GGS Medical College, Faridkot, Punjab, India
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Maymone MBC, Watchmaker JD, Dubiel M, Wirya SA, Shen LY, Vashi NA. Common Skin Disorders in Pediatric Skin of Color. J Pediatr Health Care 2019; 33:727-737. [PMID: 31655787 DOI: 10.1016/j.pedhc.2019.04.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/22/2019] [Accepted: 04/24/2019] [Indexed: 12/12/2022]
Abstract
Children with skin of color represent a large proportion of the pediatric population. There are numerous skin conditions that commonly occur in this population, including but not limited to acne, atopic dermatitis, pityriasis alba, tinea versicolor, progressive macular hypomelanosis, traction alopecia, and confluent and reticulated papillomatosis. This article highlights the clinical presentations of these conditions in skin of color and briefly addresses pathophysiology and treatment modalities.
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Albalat W, Ebrahim HM. Evaluation of platelet-rich plasma vs intralesional steroid in treatment of alopecia areata. J Cosmet Dermatol 2019; 18:1456-1462. [PMID: 31074201 DOI: 10.1111/jocd.12858] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 10/29/2018] [Accepted: 12/03/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Alopecia areata (AA) is nonscarring patchy area of hair loss. Platelets rich plasma (PRP) promotes development of new hair follicles. Dermoscopy is a diagnostic tool that helps in evaluation of skin microstructures which are not visible to naked eye. AIM To evaluate safety and efficacy of (PRP) vs intralesional corticosteroid (ILCs) in treatment of AA. PATIENTS AND METHODS This study was conducted on 80 patients of both sexes who had AA. Patients were classified into Group I treated by ILCs and group II treated by (PRP). Results were assessed by dermoscopic evaluation and by hair re-growth score (RGS) at (baseline), 2, 4, 6, 8, and 12 weeks. Patients were followed up for 6 months. RESULTS There was greater hair re-growth after treatment in both groups. In group I, (26) patients (65%) showed improvement >70% compared to 29 patients (72.5%) in group II. There was significant re-growth of pigmented hair and decrease in dystrophic hair (P < 0.001) by dermoscopic evaluation in both groups. The difference between both groups was insignificant (P = 0.57). At follow-up, two (5%) patients in group II had relapse compared to 10 (25%) patients in group I. CONCLUSION Platelets rich plasma is safe and promising therapeutic option in AA.
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Affiliation(s)
- Waleed Albalat
- Faculty of Medicine, Department of Dermatology, Venereology and Andrology, Zagazig University, Zagazig, Egypt
| | - Howyda M Ebrahim
- Faculty of Medicine, Department of Dermatology, Venereology and Andrology, Zagazig University, Zagazig, Egypt
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20
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Griggs J, Burroway B, Tosti A. Pediatric androgenetic alopecia: A review. J Am Acad Dermatol 2019; 85:1267-1273. [DOI: 10.1016/j.jaad.2019.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 07/24/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
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Rossi A, D'Arino A, Pigliacelli F, Caro G, Muscianese M, Fortuna MC, Carlesimo M. The diagnosis of androgenetic alopecia in children: Considerations of pathophysiological plausibility. Australas J Dermatol 2019; 60:e279-e283. [PMID: 31168786 DOI: 10.1111/ajd.13079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 04/24/2019] [Indexed: 01/21/2023]
Abstract
Androgenetic alopecia (AGA), one of the most common causes of hair loss in men and women, is an infrequent cause of alopecia in children. In AGA, patients generally start noticing hair thinning after the onset of puberty due to progressive miniaturisation of the hair follicle which leads to vellus transformation of terminal hair. However, the occurrence of prepubertal AGA has rarely been reported in the literature. The pathophysiology of AGA is tightly linked to androgen hormones; prepubertal children do not usually produce significant amounts of adrenal or gonadal androgens. When it does occur, an underlying abnormality should be suspected. Secondary causes of AGA must be excluded when evaluating a patient before the appearance of puberty. Premature puberty, polycystic ovarian syndrome and other causes of hyperandrogenism can present with hair loss in an androgenetic pattern. This article reviews the normal physiology of androgen hormones and their role in the pathophysiology of childhood AGA.
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Affiliation(s)
- Alfredo Rossi
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Andrea D'Arino
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Flavia Pigliacelli
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Gemma Caro
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Marta Muscianese
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Maria Caterina Fortuna
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
| | - Marta Carlesimo
- Department of Internal Medicine and Medical Specialties, UOC Dermatology, University of Rome "Sapienza", Rome, Italy
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22
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Kamyab K, Rezvani M, Seirafi H, Mortazavi S, Teymourpour A, Abtahi S, Nasimi M. Distinguishing immunohistochemical features of alopecia areata from androgenic alopecia. J Cosmet Dermatol 2018; 18:422-426. [PMID: 29790258 DOI: 10.1111/jocd.12677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Distinction between alopecia areata (AA) and androgenic alopecia (AGA) can be made according to clinical presentation and biopsy findings. However, it is sometimes difficult to differentiate them, especially when the diffuse pattern of both AA and AGA is in the differential diagnosis of hair loss in androgen-dependent areas. OBJECTIVES To evaluate the characteristics of inflammatory cell infiltration using CD3, CD4, CD8, and CD20 antigens, in AA and AGA to find some consistent histological clues for distinguishing these two entities. METHODS A retrospective analysis of patients with diagnosed AA (30 cases) and AGA (30 cases) was performed based on the clinical and histopathological criteria. We studied immunohistochemical findings for CD3, CD4, CD8, and CD20 in all selected cases. RESULTS Immunohistochemical stains for CD4 and CD20 were not helpful in differentiating AA from AGA, but the inflammation density for AA was significantly (P-value = .025, .001) higher than AGA in CD3 (specificity= 86.7% and sensitivity= 96.7%) and CD8 (specificity= 50% and sensitivity=86.6%). Our findings revealed that intrafollicular CD3 (P-value = .017) and CD8 (P-value = ˂.001) infiltrations were significantly higher in AA samples in comparison with AGA. CONCLUSION Characterization of CD3 and CD8 in IHC samples is helpful, especially when the density of CD3 and CD8 T cells are significant in more than 50% of the infiltrated cells and are located intrafolliculary. Moreover, the most specific and sensitive test for differentiating of AA from AGA is CD3.
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Affiliation(s)
- Kambiz Kamyab
- Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rezvani
- Student of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hasan Seirafi
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Samira Mortazavi
- Fellowship of Dermatopathology, Pathology Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Teymourpour
- Student of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahab Abtahi
- Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands
| | - Maryam Nasimi
- Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
Inflammatory dermatoses encompass a variety of histologic patterns that affect different portions of the skin. In spongiotic, psoriasiform, lichenoid, pityriasiform, and blistering disorders, there are predominately epidermal and junctional activities with variable superficial dermal inflammation. Hypersensitivity reactions can show either epidermal or mostly dermal changes depending on whether the exposure of the exogenous allergen occurs through an external or internal route, respectively. Exceptions include erythema multiforme and Stevens-Johnson syndrome/toxic epidermal necrolysis, where the etiology is often due to infection or ingested medications, but the histologic features are almost exclusively confined to the epidermis and dermoepidermal junction. Autoimmune disorders are unique in that lesions typically incorporate a mixture of epidermal and dermal inflammatory patterns with periadnexal inflammation, while the vast majority of vasculitis/vasculopathy and alopecia have changes limited to only the vessels and hair follicles, respectively. It is critical to recognize that a relatively limited number of histologic patterns are seen in a large array of clinical entities. Therefore, clinicopathologic correlation and careful examination of histologic details are of the utmost importance when evaluating skin biopsies for inflammatory disorders.
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Affiliation(s)
- Andy C Hsi
- 1 Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Ilana S Rosman
- 1 Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri.,2 Division of Dermatology, Washington University School of Medicine, St. Louis, Missouri
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24
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Abubucker S, Cohen BA. Visual Diagnosis: The Case of the Balding Preschooler. Pediatr Rev 2017; 38:e41-e44. [PMID: 29093128 DOI: 10.1542/pir.2016-0143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Bernard A Cohen
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD
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25
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Xu L, Liu KX, Senna MM. A Practical Approach to the Diagnosis and Management of Hair Loss in Children and Adolescents. Front Med (Lausanne) 2017; 4:112. [PMID: 28791288 PMCID: PMC5522886 DOI: 10.3389/fmed.2017.00112] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 07/04/2017] [Indexed: 12/13/2022] Open
Abstract
Hair loss or alopecia is a common and distressing clinical complaint in the primary care setting and can arise from heterogeneous etiologies. In the pediatric population, hair loss often presents with patterns that are different from that of their adult counterparts. Given the psychosocial complications that may arise from pediatric alopecia, prompt diagnosis and management is particularly important. Common causes of alopecia in children and adolescents include alopecia areata, tinea capitis, androgenetic alopecia, traction alopecia, trichotillomania, hair cycle disturbances, and congenital alopecia conditions. Diagnostic tools for hair loss in children include a detailed history, physical examination with a focused evaluation of the child’s hair and scalp, fungal screens, hair pull and tug test, and if possible, light microscopy and/or trichoscopy. Management of alopecia requires a holistic approach including psychosocial support because treatments are only available for some hair loss conditions, and even the available treatments are not always effective. This review outlines the clinical presentations, presents a diagnostic algorithm, and discusses management of these various hair loss disorders.
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Affiliation(s)
- Liwen Xu
- Harvard Medical School, Boston, MA, United States
| | - Kevin X Liu
- Harvard Medical School, Boston, MA, United States
| | - Maryanne M Senna
- Department of Dermatology, Massachusetts General Hospital, Boston, MA, United States
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26
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Chong J, Taïeb A, Morice-Picard F, Dutkiewicz A, Léauté-Labrèze C, Boralevi F. High-dose pulsed corticosteroid therapy combined with methotrexate for severe alopecia areata of childhood. J Eur Acad Dermatol Venereol 2017; 31:e476-e477. [DOI: 10.1111/jdv.14291] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J.H. Chong
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
- Pediatric Dermatology Service; KK Women's and Children's Hospital; Singapore Singapore
| | - A. Taïeb
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
| | - F. Morice-Picard
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
| | - A.S. Dutkiewicz
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
| | - C. Léauté-Labrèze
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
| | - F. Boralevi
- Department of Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin-Enfants; CHU de Bordeaux; Bordeaux France
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27
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Christensen T, Yang JS, Castelo-Soccio L. Bullying and Quality of Life in Pediatric Alopecia Areata. Skin Appendage Disord 2017; 3:115-118. [PMID: 28879186 DOI: 10.1159/000466704] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 02/24/2017] [Indexed: 11/19/2022] Open
Abstract
Alopecia areata (AA) is a clinically heterogeneous disease that is characterized by nonscarring hair loss, nail changes, and increased risk of other autoimmune disease. During clinical visits, children with AA often report bullying. We report survey results that highlight the prevalence of bullying and surrounding emotional impact of AA in pediatric patients. We found that bullying was common overall and additional psychological impact, including impairment of social and home life, was even more common. Children of all ages experienced bullying. Boys reported increased physical bullying. Interestingly, those with more severe disease and longer duration of disease experienced less bullying than those with less severe disease.
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Affiliation(s)
- Theresa Christensen
- University of Pennsylvania, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jessica S Yang
- Case Western Reserve, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Leslie Castelo-Soccio
- Section of Pediatric Dermatology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,University of Pennsylvania Perlman School of Medicine, Philadelphia, Pennsylvania, USA
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28
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John AM, Schwartz RA, Janniger CK. The kerion: an angry tinea capitis. Int J Dermatol 2016; 57:3-9. [PMID: 27696388 DOI: 10.1111/ijd.13423] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 11/30/2022]
Abstract
Tinea capitis has a high incidence with a global changing pathogen distribution, making this condition a public health concern around the world. As the infection is initially asymptomatic, it is easily spread. Moreover, it is present in many fomites, including hairbrushes, pillows, and bedding. Prompt recognition and treatment is necessary for kerion, an inflammatory subtype characterized by tender boggy plaques with purulent drainage. Kerion is usually associated with infection by zoophilic dermatophytes, although other sources have been described. Treatment for this severe form of dermatophytic infection can be challenging. In addition to the use of topical treatments, oral administration of griseofulvin, terbinafine, itraconazole, or fluconazole is often required. Griseofulvin, the first-line treatment, may not completely eradicate pathogen colonization of the host and may contribute to reinfection and prevalence of infective but asymptomatic carriers. This review highlights new agents that are being evaluated for the treatment of kerion and typical tinea capitis, enhanced diagnostic criteria, and a grading system for kerion evaluation.
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Affiliation(s)
- Ann M John
- Dermatology, Pathology, Pediatrics, and Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - Robert A Schwartz
- Dermatology, Pathology, Pediatrics, and Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA.,Rutgers University School of Public Affairs and Administration, Newark, NJ, USA
| | - Camila K Janniger
- Dermatology, Pathology, Pediatrics, and Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA
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29
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Non-dermatophyte Dermatoses Mimicking Dermatophytoses in Humans. Mycopathologia 2016; 182:101-111. [DOI: 10.1007/s11046-016-0059-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 08/24/2016] [Indexed: 11/26/2022]
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30
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Abstract
PURPOSE OF REVIEW Hair loss is common in infants and children and the ability to distinguish why a child is losing hair enables providers to distinguish hair loss that is related to infection, autoimmune conditions, nutrition, medications, trauma/traction, or underlying genetic disorders such as ectodermal dysplasias. Making these distinctions leads to best management and guidance for patients and their families. RECENT FINDINGS Careful physical examination of the hair, scalp, skin, and nails coupled with dermoscopy or trichoscopy, or both, can yield more accurate and faster diagnosis. Biopsy is rarely needed in children for hair loss conditions. SUMMARY Hair loss, particularly on the scalp, can affect all ages and can impact patients socially and emotionally. The majority of hair loss in children is nonscarring. Diagnosis begins with a good history, including personal and family history, medication use, a thorough physical examination, and use of dermoscopy or trichoscopy, or both. With these, providers can begin to divide hair loss into congenital vs. acquired, and then further subdivide into focal vs. diffuse and scarring vs. nonscarring. Secondary change, including scale and erythema, can further help with diagnosis.
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31
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Mashiah J, Kutz A, Ben Ami R, Savion M, Goldberg I, Gan Or T, Zidan O, Sprecher E, Harel A. Tinea capitis outbreak among paediatric refugee population, an evolving healthcare challenge. Mycoses 2016; 59:553-7. [PMID: 27061446 DOI: 10.1111/myc.12501] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 03/03/2016] [Indexed: 02/06/2023]
Abstract
Outbreaks of tinea capitis (TC) represent a major medical and economic burden. Population migrations have become a phenomenon of increasing relevance for medical conditions management. Given the recent massive arrival of immigrants, we sought to determine epidemiologic trends for TC among paediatric populations at the Tel Aviv Medical Center. We conducted a retrospective study of all TC cases diagnosed between 2010 and 2014 in a paediatric dermatology unit of a tertiary medical centre, serving as a referral centre for the paediatric refugee population from the great Tel Aviv area. Epidemiologic, clinical and treatment data including effectiveness and safety were reviewed. In all, 145 children met the inclusion criteria. Trend analyses showed increases in TC rates over the study period. Incidence rates were higher in boys than in girls. Children of African origin had the highest TC incidence rates as compared with other ethnic groups. Trichophyton violaceum and Microsporum audouinii were the predominant causative organisms. Treatment with griseofulvin was satisfactory in all cases. There was a significant increase in TC incidence rates in the Tel Aviv area over the study period. TV and MA were the predominant organisms. These trends may be a result of poor living conditions and crowded school premises.
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Affiliation(s)
- Jacob Mashiah
- Pediatric Dermatology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ana Kutz
- Pediatric Dermatology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronen Ben Ami
- Infectious Disease Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mihal Savion
- Tel Aviv District Health Office, Ministry of Health, Tel Aviv, Israel
| | - Ilan Goldberg
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamar Gan Or
- Pediatric Dermatology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Omri Zidan
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eli Sprecher
- Pediatric Dermatology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avikam Harel
- Pediatric Dermatology Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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32
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Cortés G A, Mardones V F, Zemelman D V. [Aetiology of childhood alopecia]. ACTA ACUST UNITED AC 2015; 86:264-9. [PMID: 26298298 DOI: 10.1016/j.rchipe.2015.06.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Accepted: 03/13/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Childhood alopecia is a relative rare event in general paediatric dermatology practice. Hair loss in children may have multiple causes, and there are different types of alopecia according to age groups. The aim of the study was to describe the clinical and epidemiological profile of alopecia in children from two Chilean paediatric hospitals. PATIENTS AND METHOD Descriptive analysis of clinical records of patients from the Dermatology Department of Roberto del Rio and Luis Calvo Mackenna Hospitals between January 2007 and June 2010. Patients with clinical diagnosis of alopecia were included. RESULTS A total of 345 clinical records were analysed, with 179 males (51.9%). The median age was 72 months. Overall, the most common diagnoses were: alopecia areata (AA), (36.8%), tinea capitis (TC), (21%), nevus sebaceous (13.2%), and tellogen effluvium (8.7%). According to age groups, in newborns, the most common causes were aplasia cutis and nevus sebaceous. In toddlers, pre-school and school children, the principal causes were nevus sebaceous, AA and TC. Trichotillomania was also significant in school children. In adolescents, nevus sebaceous, AA and tellogen effluvium were the most frequent diagnoses. AA was statistically associated with autoimmune disease, thyroid disease, nail disorder, psychiatric disease, and Down's syndrome. The most common aetiological agent in TC was M. canis (86.6%). Trichotillomania was also statistically associated to psychiatric disorders. CONCLUSIONS In this study, the main causes of alopecia in children were acquired and non-scarring alopecia. In our results, the type of alopecia varies according to age group. Some types of childhood alopecia showed a close correlation to psychiatric disorders.
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Affiliation(s)
- Andrea Cortés G
- Servicio de Dermatología, Hospital Clínico Universidad de Chile, Santiago, Chile.
| | - Felipe Mardones V
- Servicio de Dermatología, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Viviana Zemelman D
- Servicio de Dermatología, Hospital Clínico Universidad de Chile, Santiago, Chile
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