Granulomatous Scarring Alopecia Associated With Rheumatoid Arthritis: A Case Report
Studysummary This case report identified a distinct pattern of scarring alopecia with folliculocentric noncaseating granulomas, linked with granulomatous dermatitis in the breast, as a potential cutaneous manifestation of rheumatoid arthritis.
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A 54-year-old woman with a history of seropositive rheumatoid arthritis and treated breast cancer presented with scarring hair loss and a skin lesion on her breast. Histological examination revealed a unique pattern of folliculocentric noncaseating granulomas in the scalp, distinct from granulomatous alopecia areata, and noncaseating granulomas in the breast lesion, which was an area previously treated with radiotherapy. The scalp condition was associated with rheumatoid arthritis and was not linked to other skin adnexa or chronic infections. Treatment included steroids, immunosuppression, phototherapy, and TNF-α inhibitors. This case highlights a novel presentation of scarring alopecia with folliculocentric granulomas, emphasizing the need for early diagnosis and treatment to prevent permanent hair loss.
