A 78-year-old woman presented with a 1-year history of cutaneous lesions on her scalp. She was otherwise healthy, and there was no personal or family history of tuberculosis. She was treated with topical steroids for 4 months, without improvement. Physical examination showed diffuse erythematous plaques on the scalp (Figure 1), extending onto the retroauricular area and the frontal hair line, with scaling (Figure 2). The lesions did not appear to be infiltrated but were slightly atrophic. The patient did not notice any symptoms other than scalp pruritus, and specifically denied having pulmonary or osteoarticular symptoms. The findings of the rest of the physical examination were normal. A specimen from an area of alopecia was sent for histologic examination (Figure 3).
Akhdari N, Skalli HD, Lakhdar H. Erythematous Lesions on the Scalp—Quiz Case. Arch Dermatol. 2004;140(8):1003-1008. doi:10.1001/archderm.140.8.1003-g