Striae distensae - like lesions. A cause of scarring alopecia among children

OBJECTIVE: Although alopecia areata is a common problem among children, many misdiagnoses for this condition can happen. The aim of this study was to demonstrate the striae distensae as lesions that cause scarring alopecia with a great resemblance to alopecia areata.

METHODS: A total of 36 children with provisional diagnosis of alopecia areata of the scalp were assessed clinically in the Department of Dermatology and Venereology, Baghdad Teaching Hospital, Baghdad, Iraq, between June 1998 to June 2001. Their age ranged from 3–12 years and the mean + standard deviation (SD) was 7.30 + 2.59 years with equal sex ratio.

RESULTS: All patients provided for this study had a history of patchy hair loss of few months duration. Their parents denied any history of obvious trauma and many modalities of treatment had been tried without benefit. The clinical examination revealed single or multiple (1-6) (mean + SD 2.41 + 1.22) complete linear hair loss patches resembling atrophic scar that was similar to striae distensae. The histopathological examination showed atrophy of the epidermis, full replacement of the dermis by collagen bundles, and complete loss of appendages.

CONCLUSION: This is a new entity, which seems to be common among children and often confused with untreated cases of alopecia areata. This condition should be added to the differential diagnosis of patchy hair loss in children and the parents should be reassured of the cause of hair loss and no treatment therapy needed.