Accaputo Ornella, White Jonathan Michael, Kolivras Athanassios, Sadeghi Niloufar, Berlingin Evelyne, Del Marmol Véronique
Dermatology Department, Erasme Hospital, ULB, Brussels, Belgium.
Dermatology Department, Saint-Pierre Hospital, ULB, Brussels, Belgium.
Case Rep Dermatol. 2019 Jan 23;11(1):7-15. doi: 10.1159/000496328. eCollection 2019 Jan-Apr.
A 66-year-old African woman suffered from a boggy thickening of the scalp in the frontoparietal area and the vertex accompanied by headache since infancy. In her thirties, she developed diffuse hair loss in the same area. Clinical and trichoscopic examination were unhelpful, but the histopathological and radiologic findings led to a diagnosis by demonstrating thick subcutaneous adipose tissue. First described in 1935 by Cornbleet [Arch Dermatol Syphilol. 1935; 32: 688], lipedematous scalp is a rare scalp disease marked by a soft thickening of the scalp. A similar clinicopathologic entity associated with nonscarring but permanent acquired alopecia was described in 1961 by Coskey et al. [Arch Dermatol. 1961 Oct; 84(4): 619-22] and termed lipedematous alopecia. In this article, we report a rare case of lipedematous alopecia with emphasis on a trichoscopic and histopathological description with review of the literature. Our case highlights the importance of palpation during the clinical examination. It remains to be determined whether this is actually a specific disease entity or a combination of 2 separate conditions. Symptomatic treatment is advisable given the lack of robust published data on treatment. Only 40 cases of lipedematous alopecia and 52 cases of lipedematous scalp have been published in the literature. Our case is the 93rd.
一名66岁的非洲女性自婴儿期起，额顶叶和头顶区域的头皮出现肿胀增厚，并伴有头痛。在她三十多岁时，同一区域出现了弥漫性脱发。临床和毛发镜检查均无诊断价值，但组织病理学和放射学检查结果通过显示皮下脂肪组织增厚得以确诊。脂肪性头皮最早于1935年由康布利特描述[《皮肤病与梅毒学文献》。1935年；32: 688]，是一种罕见的头皮疾病，其特征为头皮柔软增厚。1961年，科斯凯等人描述了一种类似的临床病理实体，与非瘢痕性但永久性获得性脱发相关[《皮肤病学文献》。1961年10月；84(4): 619 - 22]，并将其命名为脂肪性脱发。在本文中，我们报告了一例罕见的脂肪性脱发病例，重点是毛发镜和组织病理学描述，并对文献进行了综述。我们的病例强调了临床检查中触诊的重要性。这究竟是一种特定的疾病实体还是两种不同情况的组合，仍有待确定。鉴于缺乏关于治疗的可靠发表数据，对症治疗是可取的。文献中仅发表了40例脂肪性脱发和52例脂肪性头皮病例。我们的病例是第93例。
