Pseudopelade - Hair and Scalp
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Synopsis

Pseudopelade (of Brocq; Brocq's alopecia) is an ill-defined entity thought by some to represent the end stage of various forms of cicatricial alopecia and by others to represent a primary process where scarring alopecia develops ab initio. If a definitive diagnosis of another form of cicatricial alopecia can be made based on clinical, histologic, or immunofluorescent features, then the term pseudopelade of Brocq does not apply.
Pseudopelade of Brocq usually affects middle-aged women of Northern European descent between 30 and 50 years of age. It is a rare, insidious, scarring alopecia that presents with discrete asymptomatic areas of scalp hair loss. The hair loss is permanent. In some patients, the disease is slowly progressive, but in others, it worsens during periods of activity followed by periods of no activity. The alopecia results in round, oval, or irregularly shaped, often widely distributed, and grouped bald patches on the scalp. In advanced cases, it has also been described as "footprints in the snow" with islands of hairs that persist in a background of sclerosis. Pelade is a French term for alopecia areata, so pseudopelade is supposed to resemble alopecia areata. The same "burnt-out" pattern of hair loss observed in pseudopelade can be seen in lichen planopilaris, discoid lupus erythematosus, and other forms of cicatricial alopecia.
Related topic: central centrifugal cicatricial alopecia
Pseudopelade of Brocq usually affects middle-aged women of Northern European descent between 30 and 50 years of age. It is a rare, insidious, scarring alopecia that presents with discrete asymptomatic areas of scalp hair loss. The hair loss is permanent. In some patients, the disease is slowly progressive, but in others, it worsens during periods of activity followed by periods of no activity. The alopecia results in round, oval, or irregularly shaped, often widely distributed, and grouped bald patches on the scalp. In advanced cases, it has also been described as "footprints in the snow" with islands of hairs that persist in a background of sclerosis. Pelade is a French term for alopecia areata, so pseudopelade is supposed to resemble alopecia areata. The same "burnt-out" pattern of hair loss observed in pseudopelade can be seen in lichen planopilaris, discoid lupus erythematosus, and other forms of cicatricial alopecia.
Related topic: central centrifugal cicatricial alopecia
Codes
ICD10CM:
L66.0 – Pseudopelade
SNOMEDCT:
238731001 – Pseudopelade
L66.0 – Pseudopelade
SNOMEDCT:
238731001 – Pseudopelade
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Differential Diagnosis & Pitfalls
Other cicatricial alopecias, such as:
Nonscarring alopecias:
- Lichen planopilaris
- Lupus erythematosus
- Central centrifugal cicatricial alopecia
- Morphea
- Sarcoidosis
Nonscarring alopecias:
- Alopecia areata
- Male pattern hair loss
- Female pattern hair loss
- Secondary syphilis may present with a moth-eaten appearance of alopecia. Screen for syphilis with rapid plasma reagin (RPR) or venereal disease research laboratory (VDRL) serologic tests.
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Last Reviewed:01/23/2017
Last Updated:01/15/2020
Last Updated:01/15/2020