Male pattern alopecia in Child
The prevalence of pediatric male pattern alopecia is currently unknown as there is a paucity of studies. Male pattern alopecia has been reported in children as young as 5 years. As with adult male pattern alopecia, family history is considered a strong risk factor as three-quarters of affected children report at least one parent with androgenetic alopecia and a quarter reported having a history in both parents.
Male pattern alopecia in adolescent boys is also associated with common skin conditions such as acne, atopic dermatitis, or seborrheic dermatitis.
L64.9 – Androgenic alopecia, unspecified
87872006 – Male pattern alopecia
- Tinea capitis – Acute presentation with patchy hair loss associated with pruritus. Physical examination shows erythematous patches with scale and black dots indicating broken hair shafts. Kerions are common in patients aged 5-10 years. Posterior cervical lymphadenopathy increases suspicion of the diagnosis.
- Alopecia areata – Well-demarcated hair loss, often in round and band-like distributions.
- Anagen effluvium – Acute onset hair loss days to weeks after an inciting event. Significant alopecia results, as approximately 90% of hair is in anagen at a given time.
- Telogen effluvium – Acute onset hair loss usually occurring 3-4 months after an inciting event. A positive hair-pull test is suggestive of the diagnosis.
- Trichotillomania – Presents as focal patches of non-scarring alopecia with irregular borders and broken hair shafts of varying lengths.
- Traction alopecia – Examination commonly shows hair loss along the temporal hairline with fringe sign and tenting of hair follicles.
- Discoid lupus erythematosus – Erythematous scaly plaques that lead to scarring alopecia on the scalp. Uncommon in the pediatric population.
- Drug-induced alopecia
- Loose anagen syndrome
- Hypotrichosis simplex – Possible genetic basis, presents with sparse or normal hair at birth with onset of hair loss at puberty.
- Marie-Unna hypotrichosis – Autosomal dominant inheritance, presents as sparse hair at birth with further hair loss during puberty.
- Monilethrix – Possible genetic basis, presents as sparse hair that grows slowly.
- Short anagen syndrome – Presents as abnormally short hair in children aged 2-4 years with positive hair-pull test.