A Case of Alopecia Areata Associated with Low Dosage Valproic Acid Treatment

The document presents a case of alopecia areata associated with low dosage valproic acid (VPA) treatment in a 7-year-old patient. The patient developed a localized patch of hair loss (1.5x1 cm) on the 7th day of starting VPA therapy at a low dosage of 10 mg/kg/day. Drug-induced alopecia is typically a diffuse, non-scarring type of hair loss that is reversible upon the discontinuation of the drug. VPA is recognized as a safe and effective antiepileptic drug, but it can have side effects such as weight gain, tremor, and hair loss, which may not improve with continued therapy but can respond to a reduction in dosage or a change in dosing regimen. Alopecia due to VPA is dose-dependent and has been reported in 2-12% of patients, with incidences up to 28% observed at high valproate concentrations.