Tick‐Bite Alopecia of the Scalp in a Child: Case Report and Differential Diagnosis With Alopecia Areata and <scp>SENLAT</scp>

The document discusses tick-bite alopecia in children, emphasizing the importance of identifying a bite-centered anatomy, such as a tiny eschar or atrophic papule with a narrow, active rim, to differentiate it from alopecia areata. Trichoscopic signs can overlap with alopecia areata, but rim-restricted signs around a bite center suggest tick-bite alopecia. The presence of ipsilateral tender cervical lymphadenopathy with a scalp eschar indicates SENLAT and requires empiric doxycycline treatment, while its absence suggests conservative management. Typically, a short course of high-potency topical corticosteroids is effective, with biopsies reserved for atypical cases. Ongoing follow-up is advised to monitor for rare progression to an alopecia areata-like effluvium.