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.