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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1812 - 09 May - Dr Uma Sundram Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Clinical History: 82 year old woman with hair loss.

Case Posted by Dr Uma Sundram

Edited by Admin_Dermpath


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vincenzo polizzi

Posted

Alopecia isn't my strong suit. But I want be sporty and try the same: thinking of a scarring alopecia, with lichenoid lymphocytic coat and concentric lamellar perifollicular fibrosis...LPP?

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Fernando Cabo

Posted (edited)

Scarring alopecia. Perifolicular fibrosis. Lichenoid lymphocitic infiltrate  is limited to isthmic region of follicle. I'd think lichen planopilaris. I'd like to look vertical section  to see interfollicular epitelia 

Edited by Fernando Cabo

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Dr. Mona Abdel-Halim

Posted

LPP or frontal fibrosing alopecia depending on the clinical details of the type of hair loss

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Robledo F. Rocha

Posted

Lymphocytic scarring alopecia with vacuolar interface change at the level of the isthmus (infundibulum, not shown, is also likely to be affected) in some follicles and concentric lamellar perifollicular fibroplasia that backs away the lichenoid infiltrate from other follicles. Interfollicular dermal mucin is absent. Lichen planopilaris is my opinion, but appreciating the clinical history of a postmenopausal women, the variant frontal fibrosing alopecia is favored.

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Uma Sundram

Posted

We don't get to see a lot of alopecia in practice (unless you're Dr Stefanato!) so I thought i would include a relatively straightforward example of LPP/FFA. DDX is lupus which was excluded based on lack of deep periadnexal infiltrate. CCSA is also a reasonable thing to think of but no premature desquamation is seen. There are a lot of fibrous stele in this case and noticeable number of telogen phase follicles.

 

See you in London at the London Dermatopathology Symposium!! It is going to be a great course with lots of wonderful speakers.

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