REPORT OF A CASE
A 6-year-old girl had first noted hair loss associated with pruritus in a patch on the vertex of her scalp at age 5 years. Over the subsequent year, she slowly lost more hair both in the original location as well as in new areas on her scalp. She was otherwise in good health and had no history of other hair or skin disease.She had been born in New York and had never left the United States. She had no pets, but often played with a cousin's dog. No family members or friends had had skin or hair disorders. The patient's mother was born in Puerto Rico but had lived in New York for many years.On examination, there were five irregular 1- to 2-cm patches of scarring alopecia on the vertex of her scalp, each with central erythema and scale-crust (Fig 1). Hairs were not