Strength of recommendation (SOR)
A Good-quality patient-oriented evidence
B Inconsistent or limited-quality patient-oriented evidence
C Consensus, usual practice, opinion, disease-oriented evidence, case series
A 47-YEAR-OLD AFRICAN AMERICAN WOMAN sought care at our clinic for multiple progressive scalp lesions. She said that she first noticed the lesions 13 years ago when her children were diagnosed with ringworm on the scalp. At that time, her physician thought that she, too, had tinea capitis, and she was treated with 6 weeks of griseofulvin. The lesions persisted, however.
She told us that the lesions were nonpruritic and that she didn’t have any other symptoms. The patient did not have a history of trauma or exposure of chemicals to the scalp, and she was not taking any prescription or over-the-counter medications.
Examination of her scalp revealed scattered irregularly shaped, nontender lesions that were centrally hypopigmented and peripherally hyperpigmented. She also had scarring and hair loss (FIGURE 1). She had no other lesions on her body.
FIGURE 1
Irregularly shaped scalp lesions
Our 47-year-old patient had multiple scattered scalp lesions that were nontender and centrally hypopigmented. scarring, alopecia, and surrounding areas of hyperpigmentation were also visible.
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