Citation: Starace M, Carpanese MA, Abbenante D, Bruni F, Piraccini BM, Alessandrini A. Atypical presentation of congenital triangular alopecia: a case series in Italy. Dermatol Pract Concept. 2020;10(4):e20200122. DOI: https://doi.org/10.5826/dpc.1004a122 Accepted: July 3, 2020; Published: October 26, 2020 Copyright: ©2020 Starace et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: None. Competing interests: The authors have no conflicts of interest to disclose. Authorship: All authors have contributed significantly to this publication. Corresponding author: Miriam Anna Carpanese, MD, Department of Experimental, Diagnostic and Specialty Medicine—Division of Dermatology, University of Bologna, Via Massarenti, 1, 40138 Bologna, Italy. Email: miriam.carpanese@gmail.com Background: Congenital triangular alopecia (CTA) is a benign, asymptomatic, nonprogressive, localized and noncicatricial type of alopecia that is usually first noted during infancy or childhood. The pattern of hair loss is traditionally described as triangular, oval or lancet shaped with apex toward the vertex. Objectives: We present a case series of CTA located in unusual sites. Patients and Methods: We performed trichoscopy in 78 patients with CTA. From this group, we selected 10 individuals (4 males and 6 females) whose disease was not localized on the typical scalp area. Results: The alopecic area was located on the occipital region in 5 patients, the parietal region in 4 patients, at the vertex in 1. With trichoscopy, vellus hairs were detected in all patients, and evidence of empty follicles was noticed only in 3 patients. Conclusions: In contrast with the preconceived notion that all CTAs are frontotemporal, our case series points out that this disease could be localized in other scalp sites. Keywords : congenital triangular alopecia, scalp, trichoscopy, atypical This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.