Perinevoid alopecia: an unusual presentation of alopecia areata

Citation: Machado JLR, Cortez de Almeida RF, Frattini SC, Melo DF. Perinevoid alopecia: an unusual presentation of alopecia areata. Dermatol Pract Concept. 2022;12(3):e2022112. DOI: https://doi.org/10.5826/dpc.1203a112

Accepted: November 12, 2021; Published: July 2022

Copyright: ©2022 Machado et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication

Corresponding author: Daniel Fernandes Melo, MSc MD, Address: Estrada dos Tres Rios 1200 – office 810 – Zip code 22745-052 Email address: danielfernandesmelo@yahoo.com.br

Case Presentation

A 19-year-old healthy male complained of sudden onset of asymptomatic single patch alopecia on the occiput for three months. The round patch of non-scarring alopecia surrounded a pre-existent pigmented dome-shaped compound nevus, which did not change over time ( Figure 1 ). Trichoscopic features were compatible with alopecia areata (AA), and the patient decided on conservative management.

Figure 1 .

A 1-cm diameter round patch of non-scarring alopecia surrounding a pre-existent pigmented dome-shaped compound subtype nevus on the right side of the occiput.

Teaching point

Perinevoid alopecia (PA) is an extremely rare variant of AA associated with a central generally pigmented nevus [ 1 ] . Although the pathogenesis is still unclear, it is thought that PA is secondary to an inflammatory response against nevus cells or melanocytic structures [ 1 , 2 ] . Immune cells around the nevus attack the hair follicle, similarly to the destruction of melanocytes in a halo nevus, other nevocentric phenomena [ 2 ] . Surgical removal of the nevus may lead to hair regrowth a few weeks after excision [ 1 , 2 ] . Recognizing PA is essential to properly manage this unique variant of AA.