Weir Sydney A, Awe Olufolakemi, Robbin Michelle L, Mayo Tiffany T
University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.
Department of Dermatology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama, USA.
Skin Appendage Disord. 2022 May;8(3):249-255. doi: 10.1159/000520506. Epub 2021 Dec 20.
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.
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.
脂性头皮（LS）是一种罕见病症，其特征是头皮皮下层的脂肪组织增厚，导致头皮质地柔软、呈海绵状或增厚。当与脱发相关时，这种病症被称为脂性脱发（LA）。除了组织病理学外，各种成像方式已被用于诊断LS和LA。
我们报告2例LS病例：1例为56岁女性，头顶头皮有1年的头发稀疏、疼痛和压痛病史；另1例为60岁女性，有5年扁平苔藓性毛囊炎病史，头顶有1年的瘙痒和酸痛病史。超声（US）用于诊断、治疗反应监测、常规临床检查和症状评估。随访超声显示，尽管症状改善且头发生长有视觉改善，但两例患者的头皮厚度均无改善。
讨论/结论：据报道，超声是诊断LS的有用工具；然而，通过头发生长和症状缓解能更好地评估治疗反应。我们发现，一旦通过超声做出诊断，临床监测就足够了，因为症状改善和头发生长可能与头皮厚度的变化无关。
