To the Editor Cutaneous sarcoidosis is not uncommon, and the skin can be the first and only area affected.1"5 On the other hand, permanent alopecia caused by sarcoidosis is rare and is usually characterized by a few patches of cicatricial alopecia resembling discoid lupus erythematosus.We report a case of extensive cicatricial alopecia with systemic involvement caused by sarcoidosis in a 45-year-old Italian female.Alopecia involved the scalp almost entirely, extending from the frontal hairline to the vertex and both parietal areas. The scalp was diffusely shiny and atrophic, with areas of hyper- and hypopigmentation. No signs of active inflammation were present. A few tufted hairs were irregularly distributed on the frontal and occipital hairline. The patient revealed that she had been affected by hair loss for more than 15 years, but she had never previously received any specific treatment. Moreover, a few slightly atrophic, scaly red-brown papules and plaques had recently appeared on the forehead, temples, and ears, and this finally prompted her to seek medical advice.
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