Alopecia Universalis Associated with Cutaneous T Cell Lymphoma

    January 2014 in “ Dermatology
    Mariya Miteva, Laila El Shabrawi‐Caelen, Regina Fink‐Puches, Christine Beham–Schmid, Paolo Romanelli, Francisco A. Kerdel, Antonella Tosti
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    TLDR Some patients with a type of skin lymphoma can experience a rare, non-scarring hair loss that looks like another hair loss condition but has distinct features.
    The document reports on two patients with alopecia universalis-like hair loss associated with cutaneous T cell lymphoma (CTCL). The first patient, a 71-year-old woman with the mycosis fungoides (MF) variant of CTCL, experienced almost complete hair regrowth after treatment with clobetasol and triamcinolone. The second patient, a 65-year-old woman with erythrodermic MF/Sézary overlap syndrome, did not have hair regrowth after treatment with topical clobetasol. Dermoscopic examination showed similar features in both cases, including follicular or diffuse scaling, a reduced number of follicular openings, and keratotic filiform spicules. Pathological examination confirmed CTCL-related alopecia, with findings such as altered follicular architecture, miniaturized follicles, and a lichenoid/interface lymphoid epidermotropic CD4 T cell infiltrate. The study concludes that CTCL-related alopecia universalis is a rare, non-scarring form of hair loss that can be mistaken for alopecia areata universalis, and it highlights clinical, dermoscopic, and pathological features that can help differentiate between the two conditions.
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