Psoriatic Scarring Alopecia: A Case Report

In the case report from 2013, a 42-year-old Caucasian woman with a 22-year history of severe scalp psoriasis developed scarring alopecia after experiencing increased hair shedding associated with episodes of greater inflammation and pruritus. Despite various treatments, including topical clobetasol, oral cyclosporine, methotrexate, UVB-NB phototherapy, and antibiotics, only temporary relief was achieved. Physical examination and dermoscopy revealed erythema, infiltration, scales, crusts, and a lack of follicular openings, with the right parietal side being the most severely affected. Biopsy analysis showed follicular drop-out, absence of sebaceous glands, and fibrosis, with no signs of androgenic alopecia. The findings were consistent with scarring alopecia associated with psoriatic epidermal changes. The report highlights that while hair loss in scalp psoriasis is common, scarring alopecia is a rare complication, and controlling psoriasis inflammation is crucial to prevent progression to scarring alopecia.