Case Presentation
A 19-year-old healthy male complained of sudden onset of asymptomatic single patch alopecia on the occiput for three months. The round patch of non-scarring alopecia surrounded a pre-existent pigmented dome-shaped compound nevus, which did not change over time (Figure 1). Trichoscopic features were compatible with alopecia areata (AA), and the patient decided on conservative management.
Figure 1.
A 1-cm diameter round patch of non-scarring alopecia surrounding a pre-existent pigmented dome-shaped compound subtype nevus on the right side of the occiput.
Teaching point
Perinevoid alopecia (PA) is an extremely rare variant of AA associated with a central generally pigmented nevus [1]. Although the pathogenesis is still unclear, it is thought that PA is secondary to an inflammatory response against nevus cells or melanocytic structures [1,2]. Immune cells around the nevus attack the hair follicle, similarly to the destruction of melanocytes in a halo nevus, other nevocentric phenomena [2]. Surgical removal of the nevus may lead to hair regrowth a few weeks after excision [1,2]. Recognizing PA is essential to properly manage this unique variant of AA.
Footnotes
Competing interests: None.
Authorship: All authors have contributed significantly to this publication
Funding: None.
References
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