Alopecia neoplastica is one type of cutaneous metastasis. Circulating tumor cells tend to migrate to areas with increased blood flow, which may include the scalp.
(1) Malignant cells metastasize to or around hair follicles.
(2) The metastasis may be associated with
(2a) hair loss, although this can be minor.
(2b) skin changes, although these may be inapparent
(3) The diagnosis requires scalp biopsy to demonstrate the malignant cells.
Malignancies that have been reported in association with alopecia neoplastica:
(1) breast cancer (most often)
(2) lung adenocarcinoma
(3) trophoblastic tumor
(4) gastric adenocarcinoma
(5) colon adenocarcinoma
(6) cervical carcinoma
The exclusion of other explanations for alopecia (may be co-existent):
(1) alopecia secondary to chemoradiation
(2) alopecia areata
(3) other forms of alopecia
(4) associated with eczema
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