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March 2001

A Peculiar Pattern of Alopecia

Author Affiliations


Arch Dermatol. 2001;137(3):365-370. doi:

A 54-year-old woman presented with a 1-year history of slowly progressive asymptomatic hair loss in the frontal scalp area. The patient's medical history was noncontributory, and she had been taking no medications.

Cutaneous examination revealed a frontal asymmetrical band of marginal alopecia with frontal hairline recession of 2 cm at its widest point. The skin within the area of alopecia was pale, shiny, and atrophic and demonstrated a loss of follicular orifices. The persistence of a few hairs and the contrast with the elastotic sun-damaged skin of the lower forehead area made it easy to identify the original hairline. There was a perifollicular erythema around almost all hairs at the new hairline (Figure 1 and Figure 2). The changes were less prominent at the right temple.

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