A 9-YEAR-OLD African American boy requested the cosmetic removal of 2 alopecic scalp lesions that had been present since birth (Figure 1). One lesion (Figure 2) was located on the posterior vertex of the scalp and consisted of a 10×10-mm circular atrophic scar devoid of any hair. The second lesion (Figure 3) was a 45×17-mm, lancet-shaped patch on the left temporal area of the scalp, with the point of the lesion directed superiorly and posteriorly. There were fine vellus hairs, but no terminal hairs within the zone of alopecia. The boy was otherwise healthy and had no family history of hair disorders.