Anterior, frontal congenital triangular alopecia, redundancy in therapy without improvement

Abstract

Congenital triangular alopecia (CTA) is a benign noncicatricial localized pattern of hair loss with unknown etiology. Although referred to as “congenital,” CTA may develop in adulthood. It is believed that many cases of CTA are never diagnosed or are misdiagnosed; causing the incidence to be underestimated. The present study evaluates a case of 20‐year‐old woman presenting with a single circular to oval area of hair‐loss in the mid‐frontal region of her scalp. To date, about 170 cases of CTA have been reported and we present the first case in which the alopecic patch is located in the mid‐frontal region of the scalp. We present this case not only to challenge the preconceived notion that all CTAs are frontotemporal, but also to inform other practitioners about this rare condition and prevent redundant medical treatment.

Atypical Congenital Triangular Alopecia (Brauer Nevus): Case Report and Review of Literature in Occipital and Mid-Frontal Localizations

“…Histopathological reports in atypical CTA are very limited. While no previous anatomopathological de-Skin Appendage Disord 2021;7:387-392 DOI: 10.1159/000514698 scriptions exist in occipital Brauer nevus, the microscopical findings among specimen biopsies we performed seem to be the same as those found in the cases of frontotemporal impairment, as well as in the mid-frontal samples [1,12,13]: absence of mature hairs and the pres-ence of vellus hairs in the upper dermis. The total number of follicles present is normal, although follicular size is small for the scalp.…”

“…In the same way, affection of the mid-frontal scalp is even more outstanding, with only 2 cases reported in the literature so far [12,13]. Three out of 4 patients were males, all of them with a perinatal onset and an average age of dermatologist assessment of 16.7 years old.…”

“…The development of frontal androgenetic alopecia may disguise CTA in some patients; therefore, no specific restorative treatment should be planned until then. Surgical excision as well as hair transplantation may be a therapeutic option for CTA patients [13,15,16].…”

Temporal triangular alopecia confined to the frontal scalp

“…Although two cases with congenital hair loss with vellus hair at the front area have been reported, 2,3 nevus sebaceus is included in the differential diagnosis of TTA and is sometimes hard to exclude. 2 The expression levels of AR in eccrine glands are higher in nevus sebaceus than those in healthy scalp. 4,5 AR expression levels in our case were within normal range.…”

Atypical Presentation of Congenital Triangular Alopecia: A Case Series in Italy

“…Despite the typical presentation of CTA as a triangular or oval patch of circumscribed alopecia localized in the frontotemporal area, some authors reported atypical locations of CTA in the mid-frontal region of the scalp [10], the occipital area [11], the left temporo-parietal-vertex region of the scalp [12], and the eyebrows [13]. The diagnosis of CTA is mainly based on its clinical appearance and location.…”