Hypotrichosis and Hair Loss on the Occipital Scalp

September 2023 in “ Cutis ”

Erica Possa de Abreu

hypotrichosis hair loss occipital scalp monilethrix hair shaft disorder autosomal-dominant fusiform nodules hair breakage trichoscopy light microscopy keratin gene mutations minoxidil acitretin Rogaine

TLDR A baby girl has a hair disorder called monilethrix, causing fragile hair that may improve over time.

A 6-month-old infant girl presented with hypotrichosis and hair loss on the occipital scalp, diagnosed as monilethrix based on clinical and trichoscopic findings. Monilethrix is a hair shaft disorder inherited in an autosomal-dominant pattern, characterized by fusiform nodules and fragile constrictions causing hair breakage. The condition typically manifests in the first months of life as abnormal hairs replace neonatal lanugo. Diagnosis is confirmed through clinical history, trichoscopy, and light microscopy, though genetic testing for keratin gene mutations is ideal. Management focuses on preventing hair trauma, with some cases showing improvement with minoxidil or acitretin. The prognosis varies, with potential spontaneous improvement over time.

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