Three Cases of Pseudopelade of Brocq that Had Been Misdiagnosed as Seborrheic Dermatitis / 대한피부과학회지

Pseudopelade of Brocq is a rare, idiopathic, slowly progressive hair disorder that results in cicatricial alopecia. It is characterized by multiple, small, discrete, asymmetrical, smooth alopecic patches that show little clinical inflammation. Mild pruritus and diminished lesional sensation may also be present. In addition, mild perifollicular erythema may be detected. Seborrheic dermatitis presents as chronic, papular, scaly lesion of skin, and this can be seen on the scalp. Clinically, this disease is characterized by oily, erythematous, scaly lesion. Although both diseases originally have different clinical characteristics, the early and mild scalp lesions of both diseases sometimes mimic each other. Herein, we report on 3 cases of pseudopelade of Brocq that were misdiagnosed and treated as seborrheic dermatitis.

Primary cicatricial alopecias: a review of histopathologic findings in 38 patients from a clinical University Hospital in Sao Paulo, Brazil

BACKGROUND: Scarring alopecias are classified into primary and secondary types according to the initial site of inflammation. In primary scarring alopecias, the hair follicle is the main target of destruction; the term secondary cicatricial alopecia implies that follicular destruction is not the primary pathologic event. AIMS: To review the histopathologic diagnoses of cases of cicatricial alopecia in order to classify them according to the North American Hair Research Society. PATIENTS AND METHODS: Patients with biopsy specimens diagnosed as cicatricial alopecia seen from 2000 to 2005 at the Dermatologic Department of Hospital das Clinicas, São Paulo University Medical School had hematoxylin and eosin, Periodic acid-Schiff and Weigert stained slides reevaluated and sub-typed into different primary cicatricial alopecias. RESULTS: Thirty-eight cases of primary cicatricial alopecias were reclassified as: chronic cutaneous lupus (17), lichen planus pilaris (4), pseudopelade of Brocq (12), folliculitis decalvans (3), dissecting folliculitis (1), and non-specific scarring alopecia (1). In our cases, the methods employed allowed an accurate diagnosis in 12 of 13 cases (92.3 percent) previously classified as non-specific cicatricial alopecias. CONCLUSIONS: Even in the late, pauci or non-inflammatory phases, an approach with systematic evaluation of a constellation of criteria in routine hematoxylin and eosin stain, Periodic acid-Schiff and Weigert stain allowed for a more accurate diagnosis of cicatricial alopecias.