Occipital Hair Loss in a 26-Year-Old Man

A 26-year-old man with no significant medical history presented to our clinic with an area of hair loss on his posterior scalp (Figure). He reported first noticing the hair loss 4 years prior to presentation and denied any changes to the area or development of new lesions since onset. He denied any associated symptoms, including pruritus or tenderness. A physical examination was notable for a 2.0 × 1.5 cm oval, slightly depressed, partially hairless patch on the occipital scalp. Trichoscopy demonstrated a normal scalp with vellus hairs scattered throughout the patch.