Alopecia Totalis in a Five-Year-Old Boy: A Case Report

Abstract

BACKGROUND: Alopecia totalis (AT) represent the severe form of alopecia areata with a worse prognosis. In the population, the prevalence of AT is 0.08%. This study shows that prosential, minoxidil 2%, and clobetasol propionate 0.05% could be considered hair loss treatment. CASE PRESENTATION: A 5-year-old boy weighing 13.4 kg came to the hospital complaining of hair loss all over his head, bald since 2 months before. The eyebrows, eyelashes, and nose hairs were also missing. The diagnosis is AT. The patient was given Prosential therapy for 4 months. After 2 months of treatment, hair started to grow slightly, evenly across the head, eyebrows, and eyelashes. After that, the patient was lost contact. Four months later, the patient returned with hair loss complaints again. The patient’s vital signs are normal. Eyes, ENT, heart, lungs, abdomen: normal. Skin: no hair. Laboratorium: Hb 12.1 g/dL, hypereosinophilia. Feces and urine analysis were normal. Kidney and liver function were normal. Thyroid function: FT4: 1.1 ng/dL, TsHs 0.916 uIU/mL. The ANA test was negative. Diagnosis: Idiopathic AT with hypereosinophilia. The therapy was prosential, minoxidil 2%, and clobetasol propionate 0.05%. CONCLUSION: The etiology of AT should be sought in as much detail as possible because alopecia management requires a holistic approach, including psychosocial support. Hair loss is a significant factor affecting the self-esteem of children.