Pediatric Radiation-Induced Alopecia Post Intracranial Vascular Malformation Embolization: A Case Report with Dermoscopic Findings

Radiation-induced alopecia (RIA) is an uncommon complication associated with fluoroscopy-guided neurointerventional procedures. We present a case of a 7-year-old female child who developed a well-demarcated square alopecic patch on the occipital scalp 18 days after undergoing intracranial vascular malformation embolization. Dermoscopic examination revealed multiple characteristic findings, including black dots, yellow dots, Pohl-Pinkus constrictions, tapered hairs, flame hairs, and upright regrowing hairs. The geometric shape of the alopecic patch was completely consistent with the intraoperative radiation exposure field, confirming the diagnosis of RIA. Notably, the presence of Pohl-Pinkus constrictions and tapered hairs suggests a dystrophic anagen response pattern, reflecting a less severe form of follicular damage that permits eventual hair regrowth. This case underscores the diagnostic value of dermoscopy in differentiating RIA from other common alopecic disorders, particularly in pediatric patients who have undergone neurointerventional procedures.