title: Multifocal scalp hair loss.
abstract: Cutaneous metastases from internal cancer are relatively uncommon in clinical practice, but they are very important to recognize. Metastases of skin may be a herald sign in the diagnosis of internal malignancy. Scalp metastasis from breast carcinoma is reported but it is rare. We describe a 42-year-old woman who presented with three foci of alopecia on her scalp resembling alopecia areata. She was a known case of breast carcinoma 10 years prior. Radical mastectomy and total chemotherapy was done 8 years prior. An incision biopsy of an alopecic patch was done revealing metastases of breast carcinoma to the scalp. Her workup failed to find metastatic involvement of other organs. This represents a case of breast carcinoma metastatic to the scalp mimicking alopecia areata, almost 10 years after radical mastectomy, and 8 years after chemotherapy. It is important for dermatologists to be alert for atypical features of alopecia areata, such as induration, and to maintain a low threshold for biopsy in atypical cases.
authors.affiliation: Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran. shamsadini@gmail.com
authors.forename: Sadollah
authors.initials: S
authors.lastname: Shamsadin
authors.forename: Iraj
authors.initials: I
authors.lastname: Esfandiarpoor
authors.forename: Hamid
authors.initials: H
authors.lastname: Zeinali
authors.forename: Behjat
authors.initials: B
authors.lastname: Kalantari
authors.forename: Hoseiali
authors.initials: H
authors.lastname: Ebrahimi
mesh_terms: D000328:Adult; D000506:Alopecia Areata / Q000175:diagnosis*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D001943:Breast Neoplasms / Q000188:drug therapy / Q000601:surgery; D002277:Carcinoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D003951:Diagnostic Errors; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D006801:Humans; D015409:Mastectomy, Radical; D012535:Scalp / Q000473:pathology*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*