9 years female child is suffering from these lesions for last one year. Initially lesions were much smaller and less in numbers. Each lesion size increases gradually with loss of hair and associated with mild itch. No other comorbidities except family members noticed that the child has deafness which is increasing gradually. She reads in in class III, and responds well to loud speech. As she belongs to very low socioeconomic group, her parents can't afford the treatment of her ear problem. Both TM are normal. Audiometry was once performed but reports NA. Dx and management.

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Dr Puranjoy There is a possibility of damage in ear due to immune response which is the same in alopecia Areata. Follicular melanocytes is an important target in the autoimmune process of AA, and AA may have an effect on hearing function by affecting the melanocytes in the inner ear. This is something we might need to consider. Oral methyl prednisolone or deflazacort may be needed to improve both the condition. Apart from treatment suggested by Dr Simmi. .... Not comfortable with minoxidil in children.

Hair lesions r s/o alopacia areata which may respond to intralesional canacort and minoxidil oil application. Probably she had congenital deafness, if can not be investigated at least audiometery can be done by a generous ENT expert nd hearing aid can be provided by voluntery agencies or donors as she hears louder sounds

Just for clarification It's Kenacort injection. Minoxidil is solution in alcohol not oil. But better avoided in children because over use can cause eye complications.
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Alopecia areata. Seborrhiec dermatitis Intralesional kennacort Minoxidil 2% for local application Tab biotin od Diprovate plus lotion bed time for seborrhoeic dermatitis and wash with ketaconazole shampoo

Agree with Dr.Ahemad This s ALOPECIA AERATA Government hospitals r there for the poor people. Why can't they go there ?? Hearing aid too ll be provided if needed.

@Dr. Avitus John Raakesh Prasad , Your valuable opinion please, regarding this case.

Alopecia areata...fungal (cause) Deafness may be congenital possibly sensorineural...Hearing loss>95dB Cause ..Genetic, intrauterine, perinatal or post natal. 1.Locally ketoconazole+steroid lotion.Rub it gently to the affected part. Minoxidil solution 2% as far as possible should be avoided as Dr.Avitus said. 2.Orally Tab.Biotin 5mg +multivitamin. 3.Short course of Tab.prednisolone or Deflazocort in short tapering doses. 4.Intralesional Triamcinolone acetonide.maximum dose 3 ml. per session in divided doses at multiple sites. 5.Hair wash with Ketaconazole + ZPTO lotion.

@Dr. Puranjoy Saha Alopecia Areata There is not yet any reliable cure for alopecia areata and other forms of autoimmunehairloss. Because spontaneous regrowth is common in alopecia areata, and research has often been of poor quality, the effectiveness of reported treatments is mostly unknown. Topical treatments Several topical treatments used for alopecia areata are reported to result in temporary improvement in some people. Thehairfalls out when they are stopped. These include: Potent or ultrapotenttopical steroidsMinoxidil solution or foamDithranol(anthralin) ointment Intralesional corticosteroid injections Injections of triamcinolone acetonide2.510 mg/ml into patchy scalp, beard or eyebrow alopecia areata may speed up regrowth ofhair. Its effect is temporary. If bald patches reappear, they can be reinjected. Systemic corticosteroids Oral and pulse intravenous steroids in high dose can lead to temporary regrowth ofhair. Most physicians agree that long-termsystemic steroidtreatment is not justified because of potential and actual adverse effects. Immunotherapy The sensitizing agentsdiphenylcyclopropenone(diphencyprone) and dinitrochlorobenzene provokecontact allergicdermatitisin treated areas. These sensitisers can be reapplied once weekly to bald areas on the scalp. The resultantdermatitisis irritating and may be unsightly. It is often accompanied by a swollen lymph gland.

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