Case Number : Case 2137 - 17 August 2018 Posted By: Dr. Richard Carr

cholesterol embolus

Agree. But cholesterol embolus in the skin of the scalp is definitely very rare. I usually see cholesterol emboli in the vessels of the lower extremities. And if this is scalp skin, then there is scarring alopecia (at least in these figures). Definitely need clinical history.

Cholesterol embolus appears to be incidental. Hair loss could be due to late androgenetic alopecia. The age of the patient and site make me wonder whether it is very early angiosarcoma.

I’m a bit concerned about those vessels. CD31?

cholesterol embolus

Okay we've got a little theme. You all missed the effaced rete ridges, colloid bodies in the last image and scarring like process indicating a superficial lesion e.g. superficial SCC, BCC etc that has undergone regression. Well done for spotting the "incidental" cholesterol embolism. The case was from a "backlogs" pile from St Elsewhere. I made the following report:

"No tumour seen in the multiple additional levels examined. They appearances suggest regression of a superficial lesion the nature of which is uncertain. There is cholesterol embolism in a small dermal/subcutaneous artery. Any relevant medical history of athero-embolism/cardiovascular disease?"