Yesterday in dermatology clinic I was able to see an interesting patient case of alopecia. The patient experienced some alopecia previously that resolved a few years ago with topicals . Now, she has started to notice loss of hair on her bilateral temples. She has no PMH or FHx of autoimmune or dermatological conditions.
On examination, the initial location of alopecia on her crown had resolved with good hair growth. On her temples, however, there was evidence of scarring alopecia. Interestingly, the patient also had two symmetrical scars in the same area where she had a previous facelift in another country. Our plan for this patient was to schedule a biopsy to confirm whether or not she had any remaining hair follicles in the area that would be amenable to treatment.
I found this case especially interesting because of the mixed presentation of both scarring and non scarring alopecia. Also the incidental finding of a 10-year-old scar in the same area as her new symptoms seems strange given the length of time between surgery and symptoms.
-JD
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