An Unusual Case of Congenital Triangular Alopecia on Frontal Area Successfully Treated by Surgery

Congenital Triangular Alopecia: A Case of Effective Response with 5% Topical Minoxidil in a Male Adolescent

Congenital triangular alopecia (CTA) is a rare entity of non-cicatricial alopecia characterized by triangular or oval-shaped alopecia patches on the frontotemporal region of the scalp. Few therapeutic options exist, and there is currently no effective treatment except for hair transplantation. We report the case of an adolescent boy with CTA who was treated with 5% topical minoxidil solution. During therapy, the patient showed improvement in the form of the appearance of terminal hairs, which started to show after two months of treatment. After eight months of treatment, the affected area was fully covered with dense terminal hairs. The patient did not report any adverse reactions/side effects.

Atypical Congenital Triangular Alopecia (Brauer Nevus): Case Report and Review of Literature in Occipital and Mid-Frontal Localizations

Introduction

Brauer nevus, also known as congenital triangular alopecia (CTA) is a localized alopecia that rarely affects the occipital or mid-frontal region. CTA is a localized follicular hypoplasia, commonly misdiagnosed as alopecia areata. Although named congenital, onset in adulthood is possible.

Case Presentation

We present a review of literature of eighteen atypical locations, providing 4 new cases to the 9 previously published, with particular attention to trichoscopy and histopathological descriptions in this exceptional presentation forms.

Discussion

Occipital and mid-frontal Brauer nevus are unusual findings with very few cases reported so far. Because of its rarity and atypical presentation, it can often lead to a misdiagnosis. A higher incidence in the male sex stands clear in these locations. Detection at birth is slightly more frequent than in the classical CTA. Histopathological and trichoscopy findings do not differ from the classical entity, although white or hypopigmented hairs do not seem to be an item present in the mid-frontal forms.