2024年 · 第104卷第40期

The patient, a 13-year-old male, visited the dermatology department of Zhongshan Hospital affiliated to Xiamen University on April 24, 2021 due to "multiple hair loss on the scalp for 1 week". In the past week, there was no obvious inducement to scatter the scalp in two flaky hair loss areas, and the range gradually expanded from the size of mung beans to the size of coins. A dark brown papule could be seen in the center of both hair loss areas, which appeared since childhood, and there was no itching, pain and other discomfort at the skin lesions. There is no special history of taking medication before hair loss, no special discomfort such as fever and joint pain. No previous history of local trauma, scratching, mental trauma, food and drug allergy. Dermatological examination: A round dark brown papule, about the size of a mung bean, can be seen on the left side behind the midline of the top of the head, with a slightly raised skin surface and a clear border (Figure 1). A 15 mm ×20 mm alopecia area was seen around the two papules, and the hair on it was sparse and soft. The test of light pulling hair on the edge of the alopecia area was positive, and no obvious scales or scab were seen on it. Dermatoscopy: central flat raised papules with tan background, symmetrical shape, scattered homogeneous structure and spherical structure in the center, reticular structure on the periphery, and focal distribution of linear blood vessels around it, which conforms to the manifestation of compound nevus; Empty hair follicles can be seen around the papules, black spot sign and yellow spot sign are positive, scattered exclamation mark hair can be seen, and no white homogeneous structure and cord structure can be seen (Figure 2). Diagnosis: Multiple nevus peripheral alopecia areata. Give halomethasone cream for topical treatment, 1 fingertip size at each place, once a day. During follow-up, new hair grew gradually, and hair volume grew to normal levels through 18 weeks of follow-up (Figure 3). Follow-up was as of July 1, 2024 and there was no recurrence.