Case reportSarcoidal alopecia as a mimic of discoid lupus erythematosus
Introduction
Sarcoidal alopecia is a subtype of plaque-form cutaneous sarcoidosis that can resemble the plaques of discoid lupus erythematosus (DLE). The gross and dermoscopic appearance of the two lesions can be similar, thereby leading to diagnostic confusion. Because of the systemic and progressive nature of sarcoidosis, it is important to differentiate sarcoidal alopecia from DLE so that proper treatment can be initiated, thereby avoiding the potential long-term sequelae.
Section snippets
Case 1
A 45-year-old African American woman presented with a 5-week history of plaques on her frontoparietal scalp. Her medical history was significant for pulmonary sarcoidosis, which had been diagnosed in 1998. On physical examination, the patient was shown to have Fitzpatrick phototype VI skin with annular, hypopigmented, slightly hypertrophic, indurated plaques with follicular plugging on the frontoparietal scalp (Fig 1). Even considering her history of pulmonary sarcoidosis, the clinical findings
Discussion
Sarcoidal alopecia is rare and predominantly affects African American women. In a review of published cases in 2000, 21 of 23 were female and 20 of 22 patients were African American.1
Sarcoidal alopecia is a form of secondary scarring alopecia and can have several morphologies.2 Most commonly, sarcoidal plaques located on the frontoparietal facial region may extend into the scalp, thus leading to hair loss. Such plaques are the type of sarcoidal alopecia that most closely resembles DLE.
Sarcoidal
References (7)
- et al.
Sarcoidosis of the scalp: a case series and review of the literature
J Am Acad Dermatol
(2000) - et al.
A new look at scarring alopecia
Arch Dermatol
(2000) An unusual cause of hair loss
Arch Dermatol
(2002)
Cited by (24)
Sarcoidal alopecia
2020, Annales de Dermatologie et de VenereologieThree Cases of Scalp Sarcoidosis with Alopecia
2018, Actas Dermo-SifiliograficasAnnular sarcoidosis
2017, Presse MedicaleCutaneous manifestations of sarcoidosis
2016, Annales de Dermatologie et de Venereologie
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Conflicts of interest: None declared.