Treatment Of Alopecia Universalis In A Child With Down Syndrome

A 2-year-old boy with Down syndrome (DS) experienced sudden-onset alopecia universalis (AU), losing hair across his entire body, including the scalp, eyebrows, and eyelashes. Traditional treatments for DS patients with AU often involve systemic agents, which can have variable responses and side effects. In this case, the child was treated with a combination of topical therapies: mometasone lotion 0.1%, tacrolimus ointment 0.03%, and minoxidil lotion 2%. This regimen resulted in 60% hair regrowth within four months and near-complete regrowth after six months. A minor relapse occurred when the frequency of application was reduced, but it was quickly resolved by returning to the alternate-day medication schedule. The child showed sustained improvement, indicating that combination topical therapy can be a safe, cost-effective, and efficacious treatment for severe AU in children with DS before considering systemic treatment options.