Alopecia Totalis in a Five-Year-Old Boy: A Case Report


  • Harapan Parlindungan Ringoringo Department of Child Health, Faculty of Medicine, Lambung Mangkurat University, RSD Idaman Banjarbaru, Banjarbaru, Indonesia



Alopecia totalis, Child, Idiopathic, Minoxidil 2%, Clobetasol propionate 0.05%



Alopecia totalis (AT) represent the severe form of alopecia areata with a worse prognosis. In population the prevalences of alopecia totalis, is 0,08%. This study shows that Prosential, minoxidil 2% and clobetasol propionate 0.05% therapy for hair loss could be considered

Case presentation:

A 5-year-old boy weighing 13.4 kg came to the hospital complaining of hair loss all over his head, bald since two months before. The eyebrows, eyelashes, and nose hairs were also missing. The diagnosis is alopecia totalis. The patient was given Prosential therapy for four months. After two months of treatment, hair started to grow slightly, evenly across the head, eyebrows, and eyelashes. After that, the patient was lost contact. 4 months later, the patient returned with hair loss complaints again.The patient’s vital signs are normal. Eyes, ENT, heart, lungs, abdomen: normal. Skin: no hair. Laboratorium: Hemoglobin 12.1 g/dL, leukocytes 6,480/uL, platelets 324,000/uL, hematocrit 35.5%, Diff Count: basophils 0%, eosinophils 22%, stems 1%, segments 27%, lymphocytes 41%, monocytes 9%. Feces and urine analysis were normal. Glucose 86 mg/dL, total cholesterol 128 mg/dL, triglycerides 46 mg/dL. Albumin 4.33 g/dL, globulin 1.41 g/dL. Uric acid 4.64 mg/dL. Kidney and liver function were normal. Thyroid function: FT4: 1.1 ng/dL, TsHs 0.916 uIU/mL. The ANA test was negative. Diagnosis: Idiopathic alopecia totalis with hypereosinophilia. The therapy was Prosential, minoxidil 2% and clobetasol propionate 0.05%.

Conclusion: The etiology of AT should be sought in as much detail as possible because alopecia management requires a holistic approach, including psychosocial support. Hair loss is a significant factor affecting the self-esteem of children.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


Safavi KH, Muller SA, Suman VJ, Moshell AN, Melton LJ. Incidence of alopecia areata in Olmsted County, Minnesota, 1975 through 1989. Mayo Clin Proc. 1995;70(7):628-33. PMid:7791384

Lee HH, Gwillim E, Patel KR, Hua T, Rastogi S, Ibler E, et al. Epidemiology of alopecia areata, ophiasis, totalis, and universalis: A systematic review and meta-analysis. J Am Acad Dermatol. 2020;82(3):675-82. PMid:31437543

Cho HH, Jo SJ, Paik SH, Jeon HC, Kim KH, Eun HC, et al. Clinical characteristics and prognostic factors in early-onset alopecia totalis and alopecia universalis. J Korean Med Sci. 2012;27(7):799-802. PMid:22787378

Burroway B, Griggs J, Tosti A. Alopecia totalis and universalis long-term outcomes: A review. J Eur Acad Dermatol Venereol. 2020;34(4):709-15. PMid:31593606

Tosti A, Bellavista S, Iorizzo M. Alopecia areata: A long-term follow-up study of 191 patients. J Am Acad Dermatol. 2006;55:438-41. PMid:16908349

Jang YH, Hong N-S, Moon SY, Eun DH, Lee WK, Chi SG, et al. Long-term prognosis of alopecia totalis and alopecia universalis: A longitudinal study with more than 10 years of follow-up: Better than reported. Dermatology. 2017;233:250-6. PMid:28704810

Cannalire G, Conti L, Celoni M, Grassi C, Cella A, Bensi G, et al. Rapunzel syndrome: An infrequent cause of severe iron deficiency anemia and abdominal pain presenting to the pediatric emergency department. BMC Pediatr. 2018;18(1):125. PMid:29614986

Alexander KC, Kam LH, Kin FL, Benjamin B, Joseph ML. Tinea capitis: An updated review. Recent Pat Inflamm Allergy Drug Discov. 2020;14(1):58-68. PMid:31906842

Liu FT, Goodarzi H, Chen HY. IgE, mast cells, and eosinophils in atopic dermatitis. Clin Rev Allergy Immunol. 2011;41(3):298-310. PMid:21249468

Jiero S, Ali M, Pasaribu LS, Pasaribu AP. Correlation between eosinophil count and soil-transmitted helminth infection in children. Asian Pac J Trop Dis. 2015;5(10):813-6.

Trüeb RM, Dias MF. Alopecia areata: A comprehensive review of pathogenesis and management. Clinic Rev Allerg Immunol. 2018;54(1):68-87. PMid:28717940

Messenger AG, McKillop J, Farrant P, McDonagh AJ, Sladden M. British Association of dermatologists’ guidelines for the management of alopecia areata 2012. Br Assoc Dermatol. 2012;166(5):916-26. PMid:22524397

Xu L, Liu KX, Senna MM. A practical approach to the diagnosis and management of hair loss in children and adolescents. Front Med. 2017;4:1121. PMid:28791288

Patel D, Li P, Bauer AJ, Castelo-Soccio L. Screening guidelines for thyroid function in children with alopecia areata. JAMA Dermatol. 2017;153(12):1307-10. PMid:28973128

Vano-Galvan S, Fernandez-Crehuet P, Grimalt R, Garcia- Hernandez MJ, Rodrigues-Barata R, Arias-Santiago S, et al. Alopecia areata totalis and universalis: A multicenter review of 132 patients in Spain. J Eur Acad Dermatol Venereol. 2017;31(3):550-6. PMid:27608049

Fernando T, Goldman RD. Corticosteroids for alopecia areata in children. Can Fam Physician. 2020;66(7):499-501. PMid:32675094

Tosti A, Piraccini BM, Pazzaglia M, Vincenzi C. Clobetasol propionate 0.05% under occlusion in the treatment of alopecia totalis/universalis. J Am Acad Dermatol. 2003;49(1):96-8. PMid:12833016

Wang E, Lee JS, Tang M. Current treatment strategies in pediatric alopecia areata. Indian J Dermatol. 2012;57(6):459-65. PMid:23248364




How to Cite

Ringoringo HP. Alopecia Totalis in a Five-Year-Old Boy: A Case Report. Open Access Maced J Med Sci [Internet]. 2022 Jan. 31 [cited 2022 Jul. 1];10(C):42-5. Available from:



Case Report in Pediatrics