Akademik Veri Yönetim Sistemi
33rd EADV Congress, Amsterdam, Hollanda, 25 - 28 Eylül 2024, cilt.18, ss.190, (Özet Bildiri)
Introduction & Objectives: Perinevoid alopecia is a rare variant of alopecia areata that occurs around a central pigmented nevus. Although its pathogenesis is unclear, it is thought to be secondary to an inflammatory response against nevi or melanocytic structures. Materials & Methods: We present a male patient with a central brown papule and surrounding alopecia in whom perinevoid alopecia was diagnosed on the basis of clinical and dermoscopic findings. Results: A 33-year-old male patient presented with a hairless patch around a newly noticed nevus on his scalp of 2 months’ duration. The patient had an unremarkable past medical and family history. He did not describe any local irritation. A dermatological examination revealed a 5-mm diameter brown pigmented papule, surrounded by a 1.5-cm diameter area of non-scarring alopecia in the occipital area. Dermoscopic examination showed a round melanocytic nevus with a cobblestone pattern and a surrounding alopecic patch with short vellus hairs, broken hairs and yellow dots. Wood’s light examination of the area of alopecia was negative. The patient refused biopsy. He was followed up for 5 months without treatment. No enlargement of the alopecic area or growth of the nevus was observed. Due to the patient’s cosmetic concerns, intralesional triamcinolone acetonide was applied twice with an interval of one month. After treatment, complete hair growth was achieved in the alopecic area. Conclusion: Perinevoid alopecia is an extremely rare condition characterised by an alopecic patch with a central nevus. A recent article by Zhang et al reviewed 16 cases from 12 studies between 1976 and 2023. Perinevoid alopecia was found to be more common in male patients. One of the most common localisations was found to be the occipital region, as in our case. Intradermal nevi, compound nevi, combined nevi and blue nevi were found in perinevoid alopecia cases. 5 cases had dermoscopic examination of the alopecic areas and yellow dots, black dots, exclamation mark hairs, vellus hairs and broken hairs were reported. Histopathological examination revealed the inflammatory cell infiltrate in nevus cells, hair follicles and perifollicular areas in 11 cases. The pathophysiological mechanism of the perinevoid alopecia is still unknown. It is thought that the immune cells around the nevus attack the hair follicles. The treatment options employed for perinevoid alopecia included surgical excision, intralesional steroid injections, topical steroids and minoxidil 5% solution. As in our case, intralesional steroid injections may also be a good treatment option that may mitigate the local inflammatory response in the region and stimulate hair regrowth. In conclusion, we report a case of perinevoid alopecia to provide further evidence for the occurrence of this rare entity and the effectiveness of intralesional steroid therapy, particularly for patients who prefer non-surgical interventions.