Lipedematous alopecia of the scalp

The study reported on two adult Caucasian males with lipedematous scalp, a rare condition characterized by thickening of the scalp, associated with androgenetic alopecia. This condition was previously mainly described in African-American females. The patients exhibited scalp thickening in the occipital and vertex areas, with dermoscopy revealing telangiectasia due to compression of blood capillaries by the thickened subcutaneous fat layer. Treatment with finasteride 1 mg/day for 1 year resulted in mild improvement of androgenetic alopecia in one patient and stabilization in the other, but did not change the lipedematous scalp condition. The study suggested that the association of lipedematous scalp with androgenetic alopecia was coincidental, and the condition might be underdiagnosed.