The patient is alert, oriented, and cooperative with age-appropriate vital signs. Examination reveals that the patient has a small round patch of hair loss over the left occipital region of her scalp (Figure 1) and a small oval patch of hair loss at the right temporal region with distinctive borders and no inflammation (Figure 2). Closer examination of the hair follicle reveals that the hairs are tapered toward the scalp end and thicker at the distal end. No scales, crusts, or discolorations are found on the scalp. No black dots are present on the skin. The area is smooth and does not show any abnormal dryness. No hair loss has occurred in the eyebrows, eyelashes, or pubic hair. The patient shaves her axillary and leg hair. She reports no other rashes on her body. Her skin is non-pruritic, with normal pigmentation and texture, and she reports no other changes in the hair on her body.
Small round patch of hair loss over the left occipital region of the patient's scalp. This figure is available in color online at www.jpedhc.org.
Small oval patch of hair loss at the right temporal region with distinctive borders and no inflammation. This figure is available in color online at www.jpedhc.org.
Findings of ophthalmologic, tympanic membrane, auditory canal, and nasal mucosa examinations are normal. The oral pharynx is normal without exudate, and no lymphadenopathy is noted. Lungs are clear to auscultation bilaterally, and the cardiovascular examination is within normal limits. The abdomen is symmetrical and non-distended with normal bowel sounds; no organomegaly is appreciated. Examination of the extremities reveals normal pulses and no edema or clubbing. The patient's fingernails are rigid in appearance and show stippling.
J Pediatr Health Care. 2011;25(4):261-265. © 2011 Mosby, Inc.