Ann Dermatol.  2009 May;21(2):159-163. 10.5021/ad.2009.21.2.159.

Two Cases of Linear Alopecia on the Occipital Scalp

• Rhee CH
• Kim SM
• Kim MH
• Cinn YW
• Ihm CW

• KMID: 2219386
• DOI: http://doi.org/10.5021/ad.2009.21.2.159

Abstract

Alopecia of a scalp shows various shapes and extents of hair loss, from a small round patch to polymorphous patches or total global alopecia. But alopecia of a linear shape is very rare. Only a few such cases have currently been reported in the medical literature. We recently had the chance to observe and treat two cases of linear alopecia that developed on the occipital scalp. The lesions themselves were like alopecia areata that shows a smooth bald area without any abnormality except the hair loss, but histopathologically, the lesions were compatible with lupus erythematosus profundus.

Keyword

Linear alopecia

MeSH Terms

Alopecia
Alopecia Areata
Hair
Scalp

Figure

• 

  Fig. 1 The clinical and histopathological pictures of case 1. (A) A 2 cm wide and 14 cm long smooth linear bald band traversing the occipital scalp. (B) Microscopically, there are follicular plugs and hyperkeratosis in the epidermis. The upper segments of the hair follicles, the dermoepidermal junctions and the upper dermis show no appreciable inflammatory findings. Inflammatory infiltrates are seen in the area of the eccrine glands and at the bottom of the shrinking hair follicles (H&E, ×40). (C) In the lower dermis and fat tissue, prominent lymphoid cell infiltrates are surrounding the hair bulbs and the transient parts of the follicles. Fat tissue hyaline degeneration is also well seen (H&E, ×100). (D) The fat tissue degeneration was actually abundant mucin deposition (Alcian blue staining, pH 2.5, ×100).

• 

  Fig. 2 The clinical and histopathological pictures of case 2. (A) A 2×12 cm sized linear alopecia on the occipital scalp. (B) The inflammatory infiltrates of case 2 were mainly in the perivascular area in the deep dermis. Hair follicles are in their catgen stage or they have shrunk. Hyaline fat tissue changes were also noted (H&E, ×40). (C) The hyaline fat tissue changes were mucin deposition in the subcutaneous fatty tissue (H&E, ×100).

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