Diffuse Hypotrichosis from Early Childhood

An otherwise healthy 17-year-old female presented with diffuse hypotrichosis, which had been present since early childhood. Physical examination showed erythematous keratotic follicular papules in the occipital region, and trichoscopy along with electron microscopy revealed hair with periodic constriction and nodes, giving a "rosary beads" appearance. The patient's family history included similar hair issues with her mother and aunt. The document poses questions regarding the most likely diagnosis, the etiology of the condition, and the trichoscopy findings, suggesting options such as female androgenetic alopecia, monilethrix, trichorrhexis nodosa, genetic factors, and various trichoscopy patterns, but does not provide the answers within the summary. The study implies a genetic basis for the condition, given the family history and the described symptoms.