Scalp Infection Caused by Mycobacterium Abscessus Manifested as Patchy Alopecia in an Immunocompetent Female

A 46-year-old immunocompetent woman developed patchy alopecia due to a scalp infection caused by Mycobacterium abscessus, a non-tuberculous mycobacterium typically affecting immunocompromised individuals. The infection was initially misdiagnosed due to its atypical presentation without pain or itching. Diagnosis was confirmed through DNA sequencing and histological examination, which showed granulomas. Treatment with oral clarithromycin for 3 months led to the resolution of the lesion and hair regrowth. This case underscores the importance of considering M. abscessus in differential diagnoses of alopecia, particularly when typical symptoms are absent, and highlights the potential for misdiagnosis based on clinical manifestations alone.