Contact Dermatitis Associated with Alopecia and Hyperpigmentation

The document reports on three adult cases with skin phototype V who presented with alopecia and facial dermatitis, which improved after avoiding allergens identified through patch testing. The first patient, a 43-year-old woman, had a history of hyperpigmented, pruritic patches and frontal hairline recession. Patch testing revealed positive reactions to several substances, and her dermatitis improved with allergen avoidance. The second patient, a 46-year-old woman, had hair loss and hyperpigmented pruritic patches, with patch testing positive for fragrance mix; her contact dermatitis was controlled after avoiding fragrances. The third patient, a 44-year-old woman, had eyebrow alopecia and hyperpigmentation consistent with frontal fibrosing alopecia and lichen planus pigmentosus, and reported sensitivity to sunscreen but had no positive patch test reactions. These cases support the role of allergic contact dermatitis (ACD) in alopecia and suggest that ACD and alopecia are not limited to children, emphasizing the importance of early recognition and avoidance of triggers to improve ACD and potentially alopecia.