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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 1929 - 20 Oct - Dr Richard Carr 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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F40. Patchy scarring alopecia. ?CCCA, ?LPP. Case c/o Dr Yee Wah Tsang


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Dr. Mona Abdel-Halim

Posted

Inner root sheath appears to be prematurely desquamating. Favor CCCA for clinical correlation.

 

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Agree with Mona. Scarring alopecia with premature desquamation of inner root sheath (desquamation below mid-isthmus, as is demonstrated in Figures 2 and 7 by the follicle's proximity to eccrine glands and subcutaneous fat) favors CCCA.

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Dr. Richard Carr

Posted

Thanks for your opinions. My first impression was LPP. We referred to Sperling's book and after some study ended up slightly favouring CCCA. Having found the case challenging we shared the images with Catherine Stefanato (who has an interest in alopecia) and she strongly came down in favour of lichen planopilaris.  I guess alopecia's are a challenge!

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Dr. Richard Carr

Posted

Update following sharing the clinical images with Catherine as follows:

Thanks for the feedback. Clinically CCCA but both LPP and CCCA on path. Virtually very similar...so much so I think they might be the same disease!

Catherine

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