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JAMA Pediatrics Clinical Challenge
February 2018

Hair Loss in a Young Child

Author Affiliations
  • 1Currently a medical student at University of Mississippi School of Medicine, Jackson
  • 2Department of Dermatology, University of Mississippi Medical Center, Jackson
  • 3Department of Pediatrics, University of Mississippi Medical Center, Jackson
JAMA Pediatr. 2018;172(2):193-194. doi:10.1001/jamapediatrics.2017.4340

A young girl presented for evaluation of hair loss. The mother stated that the patient was born with normal-appearing dark hair that fell out days after birth. This was replaced with “peach fuzz,” with no subsequent regrowth of normal hair. She denied pruritus. Family history was significant for similar hair loss in the patient’s maternal grandmother and maternal cousin. The patient had otherwise normal development. On physical examination, short, brittle terminal hairs of varying lengths covered the entire scalp. Follicular hyperkeratosis and perifollicular erythema were present, most prominently on the parietal and occipital scalp (Figure, A). Mild perifollicular keratotic papules were noted on the posterior upper arms. Teeth and nails showed no abnormalities. Her eyebrows and lashes were not affected. Results of trichography are shown (Figure, B).