Hair Loss and its Management in Children

Vibhu Mendiratta; Masarat Jabeen

Disclosures

Expert Rev Dermatol. 2011;6(6):581-590. 

In This Article

Focal Cicatricial Alopecia (Acquired)

Cicatricial alopecia damages hair follicles without regrowth. Stem cell failure at the base of the follicles inhibits follicular recovery from the telogen phase, thus leading to an irreversible loss of hair. Common causes of acquired focal cicatricial alopecia in the pediatric population are discussed below.

Lichen Planopilaris

Although predominantly a disease of adults, children can rarely be affected. Clinical hallmarks of active disease include perifollicular violaceous papules and follicular hyperkeratosis. Histopathology demonstrates the diagnostic features of lichenoid interface alteration. Limited disease is managed with topicalor intralesional steroids. For those with rapidly progressive or extensive lesions, steroids, retinoids or antimalarials are considered.[66–69]

Linear Scleroderma

Most often seen in the first decade of life, linear scleroderma can present on the frontal scalp extending to the forehead (en coup de sabre) as a linear shiny plaque with binding down of skin. It may be associated with underlying bony, eye and CNS defects and requires a complete radiological work up to exclude associated abnormalities. Histopathology reveals increased collagen in dermis with reduced pilosebaceous appendages. Early diagnosis is important to halt the active inflammatory phase by instituting treatment in the form of immunomodulators, such as steroids and hydroxychloroquine.[70]

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