TLDR Hair loss due to scalp metastasis from breast cancer, known as Neoplastic Alopecia, has a better survival rate than other scalp metastases and requires a biopsy for diagnosis.
The document reviewed 27 cases of Neoplastic Alopecia (NA), a rare condition where hair loss occurs due to scalp metastasis from primary tumors, predominantly breast cancer. It included a case report of an 85-year-old woman with a history of breast cancer who developed NA, diagnosed through clinical examination, dermoscopy, and histopathology. Dermoscopy was noted as beneficial for differential diagnosis, as NA lacks the classical criteria of other hair disorders. The latency period of NA varied, and its pathogenesis is believed to involve a scarring process from tumor cells. Scalp metastases generally suggest a poor prognosis, but NA-related cases have a relatively better outcome, with survival in years. Treatment options include radiotherapy, chemotherapy, and hormonal therapy, tailored to the cancer's characteristics and patient's health. Clinicians should consider NA when standard alopecia treatments fail, and a biopsy is essential for diagnosis. Recognizing NA is important as it may signal new or recurring metastatic cancer.
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