Erythematous Plaque on the Scalp With Alopecia

    July 2020 in “ Cutis
    Yu‐Qing Hu, Xueyan Yao, Cheng Zhou, Jianzhong Zhang, Yan Zhao
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    TLDR The woman has a scalp condition causing hair loss.
    A 37-year-old woman presented with a 2×6-cm, firm, erythematous plaque on the parietal region of the scalp, which had been present for 1 year. She experienced hair loss in the affected area a month before seeking medical attention. She had no history of scalp injury, was afebrile, asymptomatic, and had no family history of similar scalp disorders. The differential diagnosis included discoid lupus erythematosus, dissecting cellulitis of the scalp, follicular lichen planus, folliculitis keloidalis nuchae, and tufted hair folliculitis.
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      Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

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