Lipedematous scalp in a child

A nine year old Maori girl was noted to have a spongy consistency to her posterior scalp. The overlying skin appeared normal, as was hair growth in that area. The abnormal findings became more extensive over the subsequent year. A computerized tomography scan showed diffuse thickening of subcutaneous tissues posteriorly on the scalp. A skin biopsy specimen showed a normal epidermis with a thick layer of mature subcutaneous fat and some disruption of the subcutaneous architecture. The clinical features and investigations were consistent with a diagnosis of lipedematous scalp, which has been described predominantly in adult women and is usually associated with alopecia. This condition has not been reported previously in the pediatric literature.