LAUSR

Fig 1. Case 1. Patch of alopecia on the occipital aspect of the scalp demonstrating a large, irregular zone of marked hair loss with intact follicular ostia and abrupt transition to normal scalp (image courtesy of Dr Arash Koochek). INTRODUCTION Alopecia areata typically presents with a distinctive histopathologic pattern, including peribulbar lymphocytic inflammation with or without occasional eosinophils, follicular miniaturization, and an increase in catagen/telogen hairs. Pigment incontinence, which is proportional to the pigmentation of the patient’s hair, is often present within the peribulbar fibrous root sheath. Only 3 cases of the granulomatous variant of alopecia areata have been reported, and we now describe 2 additional cases of granulomatous alopecia areata. This histologic variant of alopecia areata represents a potential pitfall when evaluating the histopathology of a patient with hair loss. Granulomatous inflammation should not preclude the diagnosis of alopecia areata in the appropriate clinical-pathologic setting.