New England Dermatological Society: A 37-Year-Old Woman with Pruritic Erythematous Lesion Leading to Scarring Alopecia

A 37-year-old woman developed a pruritic erythematous lesion on her right breast that spread over 17 years, sparing the palms and soles, and led to scarring alopecia on her scalp. She was treated with various therapies including electron beam therapy, prednisone, vitamin A, methotrexate, and flurandrenolide cream. Examination showed scarring alopecia on the central scalp and hyperkeratotic lesions over her body, especially on the extremities, chest, and buttocks, with small plaques on her face. Laboratory tests were normal except for eosinophilia, and absorption tests for D-xylose and vitamin A were normal.