Rare Case of Alopecia: Alopecia Neoplastica

This letter to the editor discusses a rare case of alopecia neoplastica (AN), where hair loss occurs due to malignancy, specifically in a female patient in her sixties with a history of breast cancer. The patient developed patchy hair loss on the scalp, which was linked to scalp metastasis from her previous breast carcinoma. Trichoscopic and histopathological examinations revealed features consistent with metastatic adenocarcinoma of breast origin. Despite the presence of bone metastasis, the patient showed a favorable response to treatment with letrozole, palbociclib, and denosumab. The case highlights the importance of considering cutaneous metastasis as a differential diagnosis in elderly patients presenting with erythematous plaques and hair loss on the scalp. The report also notes the scarcity of trichoscopic findings in AN and the lack of histopathology-dermoscopic correlation in existing literature.