الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Alopecia is considered a common disorder in pediatric age group which differs in clinical presentation from older patients. Alopecias in children can be classified into congenital and acquired causes either originating from hair follicle or hair shaft.
It can be also classified as permenant or irreversible due to loss of hair follicle which is known as “cicatrical alopecia” or may be reversible in which hair follicle are preserved and in this case known as” non cicatrical alopecia”
According to the area affected, pediatric alopecia also can be categorized into patchy, diffuse and patterned in addition to with or without hair shaft fragility.
Non cicatrical alopecia can be caused by several disorders such as alopecia areata, tinea capitis, trichotillomania, congenital triangular alopecia, tractional alopecia and pressure induced alopecia, while cicatrical alopecia is caused by lichen planopilaris, discoid lupus erythematosus, CCCA, FFA. Hair loss can be of patchy presentation or diffuse hair loss such as telegon or anagen effluvium. Hair shaft disorders are divided into acquired or congenital conditions characterized by defects in the structure of the hair shaft with or without fragility.
Hair is considered an important component for identity and self image of the person.Children with dermatological diseases, including hair loss, usually gain many psychological poblems and they have loss self confidence.CDLQI is a simple method for assessment of quality of life in children.
This work aimed at evaluation both clinical and trichoscopic aspects of hair loss in children in addition to its impact on their quality of life.
This study was carried on 70 patients with alopecias in childhood period for assesment of personal history,medical history and family history of similar alopecias conditions or other related diseases. Clinical examination as well as trichoscopic examination of each case and applied Children Dermatology Life Quality Index for children aged from 4 to 16 years old.
In the present study 70 patients were included (48.6% males and 51.4% females). Their ages ranged from 2-16 years.The duration of their condition ranged from 0.04-15 years. There was positive consanguanity in 4 patients.
The distribution of the diagnosises of the included patients as follow: 42 patients (60%), 2 patients (2.9%), 1 patient (1.4%),1 patient (1.4%) had diagnosed alopecia areata, trichotillomania, congenital triangular alopecia, lichen planopilaris respectively while 5 patients (7.1%), 2 patients (2.9%),
4 patients (5.7%), 7 patients (10%) were diagnosed telegon effluvium, monilethrix, hypotrichosis, tinea capitis respectively, finally 2 patients (2.9%), 2 patients (2.9%),1 patients (1.4%), 1 patient (1.4%) were diagnosed nevus sebaceous, loose anagen syndrome, pressure alopecia and androgentic alopecia respectively.
The patients were divided into congenital cases and acquired cases. (12.9%) of cases were congenital including 2 patients monilethrix, 4 patients hypotrichosis, 2 patients nevus sebaceous and1 patient congenital triangular alopecia (11.4%) patients complained of diseases other than alopecias such as hypothyroidism and down syndrome. (2.9%) of patients had autoimmune diseases including systemic lupus erythematosus and vitiligo. (25,7%) of patients had positive family history of related hair problems.
All patients were complaining of hair loss (patchy hair loss in 58.6%, diffuse hair loss in 40% and patterened form in 1.4%). Associated hair loss in other areas were noticed as follow: eye lashes in 12 patients (17.1%), eye brow in 15 patients (21.4%) and body in 1 patient (1.4%).
In this study, 4 patients (5.7%) were discovered to have hair tics in cases of trichotillomania. Nail changes was found in 6 patients (8.6%). Nail changes founded in those patients were slow nail growth, pitting, ridging and leukonychia.
In all patients of alopecia areata, trichoscopy revealed (38.1%) exclamation mark,(11.9%) circle hair, (21.4%) broken hair, and (76.2%)black dot. In trichotillomania lesions there were,(100%) broken hair at different level which is specific for trichotillomania. Congenital traiangular alopecia showed vellus hair. In lichen palanopilaris patient, there were blue gray dot, peritubular scales and perifollicular scales.
In Telegon effluvium patients, upright regrowing hair was found in 60% of cases. In addition, there were 2 patients monilethrix presented by elliptical nodes separated by (50%) internodes. While in hypotrichosis patients showed white dot and short sparse hair. Tinea capitis patients showed specific trichoscopic features including comma hair, and corkscrew hair in most of cases.
Nevus sebaceous patients (n=2) showed (100%) yellowish globules in cobble stone appearance. in loose anagen hair there was (100%) black rectangular granular structures.In androgentic alopecia patient showed HSD