Nevus comedonicus (NC) is a rare developmental anomaly of follicular infundibulum plugged with keratinous material that resembles comedo-like lesions. Frequently affected sites are face, neck, trunk, and upper arm. Few cases have been described on palms, soles, scalp, and genitalia. We hereby report a rare case of NC on scalp in a 14-year-old boy.

The scalp is known to be a zone relatively immune to Mycobacterium leprae. Regardless, there have been multiple reports of multibacillary (MB) leprosy affecting the scalp. However, less than ten paucibacillary leprosy (PB) cases with scalp involvement are known, two of which also had patches of alopecia. Herein, we report the third case of 'leprotic alopecia' in a 26-year-old female secondary to PB leprosy. Although the clinical picture mimicked alopecia areata-vitiligo overlap syndrome, histopathological examination revealed borderline tuberculoid (BT) leprosy of the scalp.