Granulomatous Scarring Alopecia Associated With Rheumatoid Arthritis: A Case Report
TLDR A woman with rheumatoid arthritis had a unique type of scarring hair loss not caused by infection, requiring early treatment to avoid permanent hair loss.
A 54-year-old woman with a history of seropositive rheumatoid arthritis and treated breast cancer presented with scarring hair loss and a skin lesion on her breast. Histological examination revealed a unique pattern of folliculocentric noncaseating granulomas in the scalp, distinct from granulomatous alopecia areata, and noncaseating granulomas in the breast lesion, which was an area previously treated with radiotherapy. The scalp condition was associated with rheumatoid arthritis and was not linked to other skin adnexa or chronic infections. Treatment included steroids, immunosuppression, phototherapy, and TNF-α inhibitors. This case highlights a novel presentation of scarring alopecia with folliculocentric granulomas, emphasizing the need for early diagnosis and treatment to prevent permanent hair loss.
