eISSN: 2084-9893
ISSN: 0033-2526
Dermatology Review/Przegląd Dermatologiczny
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vol. 107
Letter to the Editor

A case of unilateral congenital triangular alopecia

Murat Ozturk
Isa An
Erhan Ayhan
Sevda Onder

Department of Dermatology, Health Sciences University, Van Training and Research Hospital, Van, Turkey
Department of Dermatology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey
Department of Dermatology, Health Sciences University, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
Department of Dermatology, Medical Faculty, Ordu University, Ordu, Turkey
Dermatol Rev/Przegl Dermatol 2020, 107, 393-395
Online publish date: 2020/10/30
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A 5-year-old male patient presented with hair loss on his scalp. It was discovered that he used topical glucocorticosteroids with the diagnosis of alopecia areata. There was no one in his family who had similar complaints. Dermatological examination revealed a patch of alopecia, approximately 5 × 3 cm in size, with normal skin color, with vellus hair on it (fig. 1). Exclamation hair and yellow-white spots were not seen (fig. 2). With these findings, the patient was diagnosed with congenital triangular alopecia (CTA).
CTA, also called temporal triangular alopecia (TTA), is a type of persistent alopecia that is asymptomatic and non-cicatricial. It usually manifests as an alopecia without any cutaneous changes limited to the frontotemporal region of the scalp. Alopecia can be triangular, oval or lancet shaped. Fine vellus hair may be present [1, 2]. The alopecic patch in our case was located in the frontotemporal region and was triangular shaped.
It is a disorder considered congenital, but it is also thought to be acquired due to the miniaturization of the hair follicles that make up the vellus hair. It is usually sporadic but rarely can be familial, and this is considered a paradominant feature [2]. CTA usually occurs at the age of 2–5, but it can also occur from birth or develop in adulthood. Although it is generally unilateral, it can be bilateral in 20% of cases. The actual incidence is unknown, because the lesions are benign and limited. In an analysis of 6200 patients, triangular alopecia was detected in 7 of the patients [3].
Li et al. reported 126 cases of CTA in the literature published in PubMed between 1905 and 2015 [4].
Down syndrome, phakomatosis pigmentovascularis, iris nevus syndrome, bone and tooth abnormalities, congenital heart diseases, mental retardation and congenital aplasia cutis have been associated with CTA [2]. There was no sign of abnormality in our case.
Dermoscopy shows normal follicular openings and vellus hair in the alopecia patch. There are no yellow and black spots or dystrophic hairs. These features distinguish CTA from other non cicatricial -cicatricial alopecias such as aplasia cutis congenita, alopecia areata and trichotillomania. In CTA, hair follicles are miniaturized and vellus hairs fill the hair follicles as in androgenetic alopecia [5]. There is no specific treatment for CTA. Therefore, it is important to make the appropriate diagnosis to avoid unnecessary treatments and interventions....

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