DOI: https://doi.org/10.36347/sjmcr.2025.v13i06.029

Pages: 1420-1422

Discoid lupus erythematosus (DLE) of the scalp is a rare and challenging diagnosis in pediatric patients, especially during early, non-scarring stages when it mimics common causes of hair loss such as tinea capitis or alopecia areata. This report describes a 9-year-old boy presenting with alopecic scalp lesions initially misdiagnosed and resistant to topical corticosteroids. Dermoscopic examination revealed characteristic features of scalp DLE, including follicular keratotic plugs and the “red spider on yellow dot” sign, facilitating early diagnosis. A biopsy confirmed the diagnosis, and systemic involvement was excluded. Given the poor response to topical therapies and the delayed effect of antimalarials, treatment with oral prednisone minipulse therapy was initiated, resulting in complete clinical remission and hair regrowth after 8 weeks without adverse effects. This case highlights the diagnostic value of trichoscopy in pediatric scalp alopecia and suggests corticosteroid minipulse therapy as a promising short-term option for managing scalp DLE in children, warranting further studies.