of a preexisting lesion, have static or burned-out lesions without scale or erythema and, as found in white patients, these lesions present as alabaster-white areas. Active lesions are inflammatory and have variable erythema and at times slight scale. The scale usually does not aggregate around the follicular orifices of remaining hair shafts to the extent encountered in lichen planopilaris. The pull test (tug test) in patients with active lesions is invariably positive for anagen hairs, a finding rarely encountered in other forms of alopecia except active lichen planopilaris and occasionally in discoid lupus erythematosus. In our experience with pseudopelade in adults, in addition to that previously described, two other clinical forms ofpseudopelademayalso beencountered: (1) a somewhat diffuse form usually centered over the crown, predominantly occurring in black women and (2) an acute fulminant form that can quickly result in extensive alopecia. We regard the histology of the active lesion as characteristic. Lymphocytes surroundand infiltrateouter sheath epithelium predominantly between the infra-infundibulum and the upper hair bulb without involvement of the bult itself. Sebaceous epithelium is usually absent or extensively involved by a lymphocyte-mediated process. In old or end-stage lesions, fibrous strands (fibrous stele) replace absent follicles and, on occasion, persistent vertically oriented naked hair shafts remain as foreign bodies. Although the collagenous adventitia ofthe follicle may be at first expanded and possibly increased, a true scar is not formed. The reticular dermis is uninvolved and remains structurally normal. The etiology of pseudopelade is unknown, but the pathogenesis in our view is a T lymphocyte-mediated inflammation ofthe outer hairsheath that ultimately results in the permanent destruction of the follicle. Although, as far as we can determine, pseudopelade has not been described in children, there is no reason why this unusual form of alopecia should be limited to adults, and we believe that the case described in this briefreport meets all the necessary criteria. We found hydroxychloroquine to be safe and effective in the management of pseudopelade in this child.