Shetty Varsha M, Shanmukhappa Asha Gowrappala, Nataraj H V, Aradhya Sacchidanand Sarvajnamurthy
Department of Dermatology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
Int J Trichology. 2021 Nov-Dec;13(6):17-25. doi: 10.4103/ijt.ijt_56_19. Epub 2021 Nov 22.
Scalp hair loss in children is one of the common complaints encountered in dermatological practice. Accurate diagnosis of hair loss in children is of major significance as it can have severe psychological implications given the cosmetic importance of hair.
This study aims to study the different causes and clinical presentations of scalp hair loss in children.
This was a hospital-based descriptive study that enrolled a total of 170 children with scalp hair loss. A detailed history, scalp, and hair examination were done. Bedside investigations such as KOH mount, hair shaft microscopy, and hair pull tests were conducted. Scalp biopsy and dermoscopy were done wherever necessary to confirm the diagnosis.
Majority of the children with scalp hair loss were school going and adolescents accounting for 62.4% of cases; 52.4% of patients were male and 47.6% were female. Asymptomatic hair loss was the most common presenting complaint contributing to 71.2% of cases. Patchy pattern of scalp hair loss formed a majority (86.5%) compared to diffuse pattern (13.5%). Around 89.4% of scalp hair loss were of acquired type and remaining 10.6% were of congenital type. Neonatal occipital alopecia (38.9%) was the most common cause of congenital hair loss. However, in the acquired group, 90.1% had nonscarring and 9.9% had scarring alopecia. In the nonscarring group, tinea capitis, alopecia areata, and telogen effluvium accounted for 47.4%, 37.9%, and 8.8% of cases, respectively.
Childhood alopecia is different from adult alopecia in terms of causes and the pattern of presentation. There is a scarcity of literature on childhood alopecia from India, hence, this study can serve as a useful guide in understanding the different causes and its presentation in our population. In addition, this study signifies the importance of simple diagnostic tests such as KOH and hair shaft microscopy in the diagnosis of common hair loss conditions in children.
儿童头皮脱发是皮肤科临床常见的主诉之一。鉴于头发在外观上的重要性，准确诊断儿童脱发具有重要意义，因为它可能会产生严重的心理影响。
本研究旨在探讨儿童头皮脱发的不同病因及临床表现。
这是一项基于医院的描述性研究，共纳入170例头皮脱发儿童。进行了详细的病史询问、头皮及头发检查。进行了床边检查，如氢氧化钾涂片、毛干显微镜检查和拔毛试验。必要时进行头皮活检和皮肤镜检查以确诊。
大多数头皮脱发儿童为学龄儿童和青少年，占病例的62.4%；52.4%的患者为男性，47.6%为女性。无症状脱发是最常见的主诉，占病例的71.2%。与弥漫性脱发（13.5%）相比，头皮脱发的斑片状模式占大多数（86.5%）。约89.4%的头皮脱发为后天性，其余10.6%为先天性。新生儿枕部脱发（38.9%）是先天性脱发最常见的原因。然而，在后天性脱发组中，90.1%为非瘢痕性脱发，9.9%为瘢痕性脱发。在非瘢痕性脱发组中，头癣、斑秃和休止期脱发分别占病例的47.4%、37.9%和8.8%。
儿童脱发在病因和表现形式上与成人脱发不同。印度关于儿童脱发的文献较少，因此，本研究可为了解我国人群中儿童脱发的不同病因及其表现提供有用的指导。此外，本研究表明了简单诊断试验如氢氧化钾涂片和毛干显微镜检查在儿童常见脱发疾病诊断中的重要性。
