Lipedematous alopecia is a rare disorder of uncertain etiology. It may be underdiagnosed.
Proposed mechanisms: hormonal, immune, lymphatic disorder
Early studies reported occurrence primarily in adult black females, but it can occur in both men and women of different races.
Clinical features:
(1) thickening of the scalp with induration
(2) pruritis and/or pain in affected scalp
(3) patchy or diffuse non-scarring alopecia
(4) variable depigmentation
If alopecia is absent then the condition is termed lipedematous scalp.
Histology shows:
(1) increased subcutaneous fat
(2) dermal edema
(3) ectatic lymphatics
Diagnosis requires exclusion of other causes, especially SLE.
Some patients have improved with mycophenolate mofetil therapy, suggesting an immune mechanism.
