Multiple, Hereditary Dome-Shaped Papules and Acrochordons: Birt-Hogg-Dube Syndrome

A 5-year-old boy was evaluated for a solitary patch of hair loss that began 8 weeks prior, initially presenting as an inflamed plaque of alopecia on the left frontal area. Despite treatment with oral antibiotics, the lesion persisted, leading to further examination. The affected area was a 3×3-cm erythematous, crusted, scaling patch with broken hairs, but without purulent drainage or follicular pustules. The boy's social history included exposure to pets, and diagnostic tests such as Wood light fluorescence and potassium hydroxide preparation were nondiagnostic. However, a fungal culture of the affected area showed some growth after 5 days.