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A Triangular Alopecic Patch on the Right Frontotemporal Scalp of a 42-year-old Man
Ching-Po , Wang Pa-Fan , Hsiao Yu-Hung Wu , Yang-Chih Lin
Dermatol Sinica 24:297-298,2006

  A 42-year-old man presented with a triangular to lancet-shaped alopecic patch which appeared on his right frontotemporal scalp since 5-year-old (Fig. 1). The alopecic patch remained stable and hadn’t enlarged nor regressed in the following years. The involved scalp was not inflamed. There was no atrophy, no erythema and no follicular plugging. Neither black dot nor “exclamation point” hair was noted. There was no similar condition in his family, and he denied any trauma or chemical injury. He had been treated with topical steroid ointment and intralesional steroid injection, but in vain. Laboratory investigations, including complete blood count, anti-nuclear antibody, thyroxine(T4) and thyroid stimulating hormone, were within normal limit.
  Two 4 mm punch biopsies revealed non-inflammatory dermis and epidermis. Most terminal hairs were miniaturized and became vellus hairs. The total hair number was normal, but the vellus hairs increased prominently.

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