Atrichia Congenita with Papular Lesions: A Report of Rare Case Showing “Cluster of Stars’ Appearance on Dermoscopy”

Atrichia congenita with papular lesions (APL) is a rare autosomal recessive form of alopecia with multiple keratin cysts. A 12-year-old boy with generalized alopecia who was unsuccessfully treated with multiple topical and systemic medications was brought to our department. Thorough history, examination and investigations confirmed the diagnosis of APL as the patient fulfilled the proposed criteria required to diagnose the condition. He also had a distinct previously observed dermoscopic clue "Cluster of Stars" appearance. The present case is reported to familiarize the clinician about this rare entity which not only helps in making proper diagnosis but also avoid unnecessary treatment as it mimics many similar conditions such as alopecia universalis, Vitamin D dependent rickets, and ectodermal dysplasia.