Pediatric emergency medicine trisk 1844 1844

FIGURE 88.23 Inflammation characteristic of a kerion In the differential diagnosis of patchy hair loss, as is seen in tinea capitis, the clinician should consider alopecia areata ( Fig 88.24 ) However, with alopecia areata, no inflammation or scaling of the scalp occurs Trichotillomania (also trichotillosis ), the term given to the habit children develop of rubbing, twirling, or playing with their hair to the point that the hair breaks and is lost in irregular sometimes geometric patches, should also be considered Hairs are characteristically of different length within the affected area, indicating breakage at different times In addition, there is no scaling or inflammation typically seen Traction alopecia occurs with certain hairstyles Hair is lost at the margins of the hairline with the ponytail style or frequent use of tight hair styles At times, papules or pustules occur where the skin has been disrupted by the traction Infants who are left on their backs for long periods may lose hair at the occiput from the constant friction in that area