Sarcoidosis of the scalp can result in alopecia. Scalp involvement may occur in the setting of systemic disease, as an isolated finding or as the presenting feature.
Mechanism: usually scarring alopecia (cicatricial)
Clinical and pathologic features:
(1) The patient shows evidence of alopecia, which is typically patchy.
(2) Biopsy of involved skin shows noncaseating granulomas.
(3) Other causes of granulomatous inflammation (mycobacteria, fungus, foreign body, etc) and cicatricial alopecia are excluded.
(4) The diagnosis is supported if there is evidence of systemic disease.
Dermoscopy may show:
(1) follicular and perifollicular yellow to orange round spots
(2) a reduction in follicles in the areas of alopecia.
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