Atrichia with papular lesions mimicking alopecia areata universalis

A 20-year-old man presented with complete hair loss on the scalp and body since infancy, along with skin-colored papules that developed from age 3. These symptoms were initially suspected to be alopecia areata universalis but were diagnosed as atrichia with papular lesions (APL) after clinical examination and histopathological analysis. The examination revealed the absence of hair follicles and the presence of keratin-filled cysts, with no systemic involvement or abnormalities in vitamin D, calcium, phosphate, and parathormone levels. The diagnosis was confirmed based on the absence of normal hair follicles and the presence of dermal cysts containing keratinous material.