Lipedematous Alopecia: Clinical, Histopathological, and Trichoscopic Findings of a Single Case and Review of the Literature

Accaputo, Ornella; White, Jonathan M. L.; Kolivras, Athanassios; Sadeghi-Meibodi, Niloufar; Berlingin, E.; Marmol, Véronique Del

doi:10.1159/000496328

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…Since its first appearance in literature, there have been about 100 cases of LS/LA reported to date. The pathophysiology of LS and LA remains unclear, but the hallmark of these two diseases is a thickening of the subcutaneous tissue, approximately double that of a healthy scalp [ 7 ]. The mechanism behind hair loss in LA is postulated to be due to the increased thickness of the subcutaneous tissue that leads to a disruption of the blood supply to the hair bulb, resulting in follicular atrophy [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Lipedematous Scalp: Presentation of a Rare Dermatological Condition

Huang,

Hudson,

Connolly

et al. 2024

Cureus

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Lipedematous scalp (LS) and lipedematous alopecia (LA) are uncommon dermatological conditions characterized by lipid accumulation within scalp tissue, leading to a thickened and boggy scalp. While the exact cause remains elusive, these conditions are believed to be on a spectrum of the same underlying disease process. LS/LA patients can experience dysesthesia of the scalp, but LA is associated with additional hair growth abnormalities. The pathogenesis remains poorly understood, with some cases suggesting a link to hormone leptin dysregulation and/or hyperlipidemia. We present a 73-year-old African American female with a medical history of hypertension, hyperlipidemia, and partial thyroidectomy who presented to the clinic with a two-week history of an itchy, burning 'rash' on the scalp. Physical examination showed normal hair density, but palpation revealed scalp edema and diffuse bogginess. While blood tests were mostly normal, she had an elevated antinuclear antibodies (ANA) titer (1:160). A punch biopsy revealed lichenification, but subsequent non-contrast magnetic resonance angiography (MRA) showed increased scalp fat tissue measuring up to 11 mm, confirming the diagnosis of LS. The patient was reassured that this finding was benign; however, she continued to experience dysesthesia. Our patient experienced minimal relief with topical steroids, leading to the consideration of intralesional steroid injections. The case highlights the importance of recognizing and managing LS as a distinct dermatological entity that requires further research to elucidate underlying mechanisms and establish standardized treatment protocols for this condition.

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Section: Discussionmentioning

confidence: 99%

Lipedematous Scalp: Presentation of a Rare Dermatological Condition

Huang,

Hudson,

Connolly

et al. 2024

Cureus

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Ultrasound Is Not Useful in Monitoring Lipedematous Alopecia: A Clinical, Trichoscopic, Histologic, and Ultrasound Analysis of 2 Cases

Weir

Awe

Robbin³

et al. 2021

Skin Appendage Disord

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Introduction: Lipedematous scalp (LS) is a rare condition characterized by thickened adipose tissue in the subcutaneous layer of the scalp resulting in a soft, spongy, or thick consistency of the scalp. When associated with hair loss, this condition is called lipedematous alopecia (LA). Various imaging modalities have been used to diagnose LS and LA along with histopathology. Case Presentation: We present 2 cases of LS: a 56-year-old female with a 1-year history of hair thinning, pain, and tenderness at the vertex scalp and a 60-year-old female with a 5-year history of lichen planopilaris presenting with a 1-year history of itching and soreness on the crown of her head. Ultrasound (US) was used for diagnosis, treatment response surveillance, routine clinical examination, and symptom assessment. Follow-up US revealed no improvement in scalp thickness in either case despite symptom improvement and visual improvement in hair growth. Discussion/Conclusion: US has been reported as a helpful tool in the diagnosis of LS; however, treatment response was better approximated by hair growth and symptom alleviation. We found that once the diagnosis with made with US, clinical monitoring is adequate as symptom improvement and hair growth may not correlate with a change in scalp thickness.

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Alopecia - overview, causes and current treatment options

Marques¹,

Tánczosová²,

Arenbergerová³

2020

Dermatol. praxi

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Alopecie představují v dermatologii komplexní téma. Různá onemocnění mohou ovlivnit vlasy mnoha způsoby. Včasná diagnóza hraje v trichologii klíčovou roli, zejména s ohledem na jizvící alopecie, kde mohou být změny vlasového folikulu související s onemocněním nevratné. Předkládáme přehled této skupiny chorob se zaměřením na nejčastější formy alopecie, s nimiž se v praxi můžeme setkat.Klíčová slova: nejizvící alopecie, jizvící alopecie, trichoskopie. Alopecia -overview, causes and current treatment optionsAlopecia is a complex chapter in the field of dermatology. Multiple diseases can affect hair differently. Early diagnosis plays a key role in the treatment of this disorder, especially in regards to cicatricial alopecia, where some disease related changes might be irreversible. We present a short review of this group of disorders, with a special focus on the most common forms of alopecia that one can encounter in Europe.

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Lipedematous Alopecia: Clinical, Histopathological, and Trichoscopic Findings of a Single Case and Review of the Literature

Cited by 3 publications

References 22 publications

Lipedematous Scalp: Presentation of a Rare Dermatological Condition

Lipedematous Scalp: Presentation of a Rare Dermatological Condition

Ultrasound Is Not Useful in Monitoring Lipedematous Alopecia: A Clinical, Trichoscopic, Histologic, and Ultrasound Analysis of 2 Cases

Alopecia - overview, causes and current treatment options

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