A Bald Spot on an Infant's Scalp

Introduction. A healthy 4-month-old infant girl presented to the clinic with her mother after the mother noticed the infant scratching an itchy rash on her torso. 

History. The infant was born full term with no complications. During the physical examination, a scalp lesion (Figure 1) was incidentally noted. The lesion was found to have a patch of excess hair surrounding the site.  There were no other similar lesions on the skin. A papulosquamous eruption was seen on the trunk and treated as atopic dermatitis. The itchy rash was clinically consistent with atopic dermatitis and treated with a topical steroid.  No atopic changes were noted on the scalp. The patient’s mother stated that she was aware of the lesion on the scalp, which she was told was just a scar from a scalp monitor during labor.

Figure 1. A lesion on the scalp of a 4-month-old infant is shown.

Diagnostic testing. An ultrasound of the head did not reveal any bony defects or underlying malformations.