先天性三角形脱发10例临床分析

Clinical analysis of 10 cases of congenital triangular alopecia

目的观察先天性三角形脱发的临床特点。方法收集厦门市儿童医院2020年8月至2021年6月诊治的10例先天性三角形脱发患儿的临床资料,分析其临床及皮肤镜特征。结果10例患儿均为男性,年龄2个月至6岁4个月。6例患儿出生时或者出生后1月内发现脱发,4例为4个月至6岁。脱发情况:5例位于左侧额颞部,3例位于右侧额颞部,2例位于头顶部。患儿脱发区均可见毳毛样毛发,拉发试验均阴性,其中1例毳毛样毛发区散在正常毛发。皮肤镜检查:脱发区边界较清,可见大量毳毛样毛发,周围为正常毛发,未见黄点征、黑点征及感叹号状发。7例曾因脱发就诊于皮肤科,其中5例被诊断为斑秃,2例被诊断为皮脂腺痣。结论先天性三角形脱发常见于儿童,好发部位为左侧额颞部。脱发区正常毛发被细的毳毛样毛发代替是该病的特点,皮肤镜有助于诊断和鉴别诊断。

ObjectiveTo investigate clinical features of congenital triangular alopecia.Methods Clinical data were collected from 10 children with congenital triangular alopecia,who were diagnosed and treated in Xiamen Children's Hospital from August 2020 to June 2021,and their clinical and dermoscopic features were analyzed.ResultsAll the 10 patients were males,aged from 2 months to 6 years and 4 months.Hair loss occurred at birth or within 1 month after birth in 6 children,and occurred between the age of 4 months and 6 years in 4.The alopecic area was located in the left frontotemporal region in 5 patients,in the right frontotemporal region in 3,and in the vertex region in 2.In all the patients,thin vellus hair could be seen in the alopecic areas,and the hair pull test was negative,while in I patient showed some normal terminal hair scattered in the alopecic area.Dermoscopy showed a lot of vellus hair surrounded by normal terminal hair in the alopecic area with a clear boundary,and no yellow or black dots,or'exclamation mark'hair was observed.Seven patients had visited department of dermatology due to hair loss,of whom 5 were diagnosed with alopecia areata,and 2 with sebaceous nevus.Conclusions Congenital triangular alopecia is common in children,and mostly occurs in the left frontotemporal region.It is characterized by the replacement of normal terminal hair by thin vellus hair in the alopecic area.Dermoscopy is helpful in its diagnosis and differential diagnosis.