Cutaneous angiosarcoma of the face and scalp presenting as alopecia

An 83-year-old woman presented with a 6-month history of hair loss and painless bruising on her forehead and scalp, which was diagnosed as cutaneous angiosarcoma through a skin biopsy. The biopsy revealed a significant increase in miniaturized and telogen hair follicles, along with some tumor-associated scarring hair loss. She was treated with the chemotherapeutic agents paclitaxel and docetaxol, but treatment was stopped due to lack of response and adverse effects. The study noted that alopecia is an uncommon presentation in angiosarcoma, with a mixed pattern of focal scarring and follicular miniaturization observed only in tumor-involved areas. The researchers speculated on the tumor's direct role in follicular miniaturization and alopecia, discussing potential implications for future treatment strategies.