Abstract
Alopecia Areata is a common non-scarring hair loss disorder frequently misidentified as Tinea Capitis in paediatric practice, particularly when mycological investigations are unavailable. We report an 8-year-old girl who presented with a solitary, smooth, well-demarcated alopecic patch at the vertex scalp of two months' duration, with mild anaemia on haematological evaluation supporting a non-infective aetiology. Prior treatment with oral antifungals had yielded no improvement. Clinical examination — intact follicular ostia, absent perifollicular scaling, and no broken hair stumps — confirmed Alopecia Areata, excluding Tinea Capitis, Trichotillomania, and Traction Alopecia. In Ayurvedic nosology, this corresponds to Indralupta, attributed to Vata-Pitta vitiation causing Rakta Dushti at the Romakoopa. A single session of Jalaukavacharana (therapeutic leech application) was performed as Raktamokshana, classically preferred in children given their Sukumara (delicate) constitution and lower tolerance for aggressive bloodletting techniques. Partial hair regrowth (25–50%) was observed at four-week follow-up. With parental informed consent, this image documents a preventable diagnostic error and provides, to our knowledge, rare photographic evidence of Jalaukavacharana for paediatric Indralupta in indexed literature.

Key words: Alopecia Areata; Indralupta; Jalaukavacharana; Raktamokshana; Pediatrics; Tinea Capitis; Kaumarbhritya