A Case of Congenital Alopecia Areata Successfully Diagnosed by Integrating Clinical, Trichoscopic, and Scalp Biopsy Findings.

Congenital alopecia areata is a rare and diagnostically challenging disease. Histopathological findings are helpful for diagnosis; however, patients and their guardians might be reluctant to give consent for skin biopsies due to their concern about the invasiveness of the procedure and potential scar formation at biopsy sites. Herein, we report a case of congenital alopecia areata in which a biopsy procedure was essential for the final diagnosis, even though clinical and trichoscopic findings were suggestive of the condition. Based on a literature review, no non-invasively obtainable and reliable finding exists for diagnosing congenital alopecia areata and, therefore, scalp biopsy still holds diagnostic significance.