Page:Skin Diseases of Children.djvu/18

2 occurs in children as well as in adults, and is very apt to be mistaken for the commoner disease, to which it may bear a strong resemblance. Its distinguishing features are the signs of inflammation in incipient patches, the groups of dark plugged follicles, and the atrophied or cicatrized appearance of the bald patches, which are usually numerous and small. In very rare cases of ringworm of the scalp a smooth, bald patch results (Fig. 1). Whether this is to be regarded as a peculiar form of ringworm (so-called bald ringworm), or as a case of alopecia

Fig. 1.—Bald ringworm.

areata developing on the site of trichophytosis, is a vexed question.

In true alopecia areata we have as essential clinical features the development of the disease in one or more small, rounded patches; the extension of these patches by a loosening and falling of the hair at a portion or the whole of the periphery; and a marked tendency to spontaneous recovery. The first bald spot in this affection may occur upon any portion of the scalp, and is usually the size of a ten- cent piece or larger when first