Prominent follicular mucinosis with diffuse scalp alopecia resembling alopecia areata


Nicole M. Burkemper, MD,

Department of Dermatology, Saint Louis

University School of Medicine, 1755 South

Grand Blvd., St. Louis, MO 63104, USA

Tel: +1 314 256 3430

Fax: +1 314 256 3431



A 56-year-old Caucasian female presented with a 2-month history of alopecia. On examination, she had diffuse hair loss of her scalp with some discrete patches of nonscarring alopecia. Histopathology revealed an inflammatory nonscarring alopecia with prominent follicular mucinosis and findings suggestive of alopecia areata. The patient's alopecia completely resolved with oral prednisone. The histopathologic findings and clinical presentation are most consistent with a diagnosis of alopecia areata with follicular mucinosis, although the differential diagnosis is broad. As follicular mucinosis may be associated with both benign and malignant conditions, it is important to be cautious regarding the clinical diagnosis when this reaction pattern is observed histopathologically.