Aching Alopecia: A Case of Giant Cell Arteritis in a 70-Year-Old Woman

A 70-year-old woman experienced scalp tenderness, progressive hair loss, and diffuse shoulder pain, which were initially misattributed to aging. Upon examination, she presented with bilateral patches of alopecia in the temporal regions and an elevated erythrocyte sedimentation rate. A biopsy of the temporal artery revealed signs of giant cell arteritis, including a narrowed lumen and an inflammatory infiltrate with giant cells. Treatment with prednisone improved her pain, but hair loss continued, and scalp necrosis developed a month later, which healed slowly with simple wound dressings. This case highlights that progressive painful bitemporal hair loss can be a manifestation of giant cell arteritis, a condition that should be considered in differential diagnoses beyond common causes of scalp tenderness such as androgenic alopecia, telogen effluvium, and zoster.