Alopecia Neoplastica Simulating Alopecia Areata and Predating the Detection of Primary Breast Carcinoma

    February 1994 in “ Journal of Cutaneous Pathology ”
    Henry J. Carson, Edmund V. Pellettiere, Edward B. Lack
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    TLDR A woman's hair loss was initially mistaken for a common hair loss condition but was later found to be caused by breast cancer cells in her scalp.
    In 1994, a case study described a 42-year-old woman who was initially diagnosed with alopecia areata due to focal hair loss but was later found to have metastatic breast carcinoma in her scalp after a biopsy, leading to a diagnosis of alopecia neoplastica. This rare condition occurs when breast cancer cells spread to the scalp and imitate the symptoms of alopecia areata. The case underscored the necessity for healthcare providers to consider malignancy as a potential underlying cause when alopecia does not respond to standard treatments. The study also pointed out the rarity of skin metastases from carcinoma, with breast cancer being the most frequent primary source of skin metastases in women, occurring in 2.3% to 4.4% of cases. It stressed the importance of immunoperoxidase staining for identifying unusual cells when the origin is unclear.
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