Cicatricial alopecia associated with pemphigus

Area of Science:

• Dermatology
• Immunology
• Autoimmune Diseases

Background:

• Pemphigus is a chronic autoimmune bullous disease.
• It involves autoantibodies against desmosomal proteins like desmogleins 1 and 3.
• Diagnosis can be challenging with atypical presentations.

Purpose of the Study:

• To present a case of pemphigus with unusual scalp manifestations.
• To emphasize the diagnostic considerations for cicatricial alopecia.
• To highlight the role of skin biopsies in diagnosing inflammatory dermatoses.

Main Methods:

• Clinical examination of an 83-year-old woman with scalp alopecia and forehead lesion.
• Review of previous biopsy results (atrophic actinic keratosis).
• Performance of new skin biopsies on the scalp for histopathological examination.

Main Results:

• The patient presented with suspicious cicatricial alopecia and an eroded forehead lesion.
• Previous biopsy was interpreted as atrophic actinic keratosis.
• New scalp biopsies were performed to investigate suspected inflammatory disease.

Conclusions:

• Atypical presentations of pemphigus can mimic other dermatological conditions.
• Cicatricial alopecia warrants a thorough differential diagnosis, including autoimmune blistering diseases.
• Skin biopsies are crucial for accurate diagnosis of inflammatory scalp conditions.