Granulomatous Alopecia Areata: A Rare Report With a Review

This document reports a rare case of granulomatous Alopecia Areata (AA) in a 42-year-old man, characterized by sarcoidal granulomas around hair follicles without any associated systemic conditions. The study highlights the importance of clinicopathological correlation in diagnosing granulomatous AA and differentiating it from other granulomatous conditions like tuberculosis, leprosy, and sarcoidosis. The case adds to the limited number of reported instances, bringing the total to 6, with no prior trauma or inciting events noted in these cases. The findings suggest that granulomatous inflammation in AA may be due to exposure to hair antigens or follicle destruction, potentially activating the T-helper 1 pathway.