A Tricky Case of Hair Loss in a Child: Trichoscopy Saves the Day

    January 2018 in “ Indian dermatology online journal ”
    Sidharth Sonthalia, Abhijeet Kumar Jha, Vishal Gupta, Aimilios Lallas
    TLDR Trichoscopy helped diagnose and cure a child's hair loss caused by a fungal infection.
    In 2018, a 7-year-old Indian girl presented with asymptomatic hair thinning on the sides and back of her scalp. Despite various treatments, including oral iron and multivitamin supplements, betamethasone, 2% minoxidil lotion, and oral fluconazole, there was no improvement. The initial diagnoses considered were noninflammatory tinea capitis (TC), diffuse alopecia areata (AA), and trichotillomania (TTM). However, trichoscopy, a noninvasive technique, revealed several "comma," and "corkscrew" hairs, which are specific to TC. The patient was treated with oral terbinafine and 2% ketoconazole shampoo, and the diagnosis of TC was confirmed when the fungal culture reported growth of Trichophyton violaceum. The child was completely cured by the 6th week of treatment. This case highlighted the utility of trichoscopy in diagnosing alopecia in children and starting the optimal treatment without delay.
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