CD8-Positive Mycosis Fungoides Clinically Masquerading as Alopecia Areata

A 33-year-old female with a 7-year history of CD8-positive hypopigmented mycosis fungoides (MF) presented with a large alopecic patch on her frontal scalp, clinically resembling alopecia areata (AA). A scalp biopsy revealed non-scarring inflammatory alopecia with a superficial band-like atypical lymphoid infiltrate, predominately CD8-positive lymphocytes surrounding hair follicles. Treatments included topical bexarotene, corticosteroids, phototherapy, and intralesional triamcinolone injections, with minimal hair regrowth. This case underscored the importance of scalp biopsies in patients with cutaneous lymphoma presenting with alopecia to determine the cause of hair loss.