Cutaneous angiosarcoma of the face and scalp presenting as alopecia.
An 83-year-old woman presented with a 6-month history of hair loss and painless bruising involving her forehead and scalp. She was otherwise well. Skin biopsy of her scalp confirmed angiosarcoma with a significant increase in miniaturized and telogen hair follicles and some tumour-associated scarring hair loss. She was commenced on the chemotherapeutic agent paclitaxel and then subsequently the semi-synthetic taxane docetaxol. Treatment was terminated because of lack of response and adverse effects. Alopecia is an uncommon presentation in angiosarcoma and in this case there was a mixed pattern of focal scarring and follicular miniaturization. The latter was present only in areas of tumour involvement and not in a typical pattern distribution for androgenetic alopecia. The direct role of tumour in follicular miniaturization and alopecia is speculated and the implications of this for novel future treatment strategies is discussed.
Murray
Stuart
S
Department of Dermatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Simmons
Ivan
I
James
Craig
C
D000368:Aged; D000369:Aged, 80 and over; D000506:Alopecia Areata / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D018450:Disease Progression; D005148:Facial Dermatoses / Q000188:drug therapy / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006394:Hemangiosarcoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D009367:Neoplasm Staging; D010166:Palliative Care; D012536:Scalp Dermatoses / Q000188:drug therapy / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*