A 65-year-old male
had a six-month history of alopecia and thickening of the scalp. He had no history
of seizures or any significant past medical history. General physical examination
was normal with proportionate length of trunk and limbs. There was no lymphadenopathy
or organomegaly and his systemic examination was unremarkable. Scalp revealed
bilaterally symmetrical longitudinal gyrate folds of skin involving the entire
scalp with loss of scalp hair (Fig 1a and 1b). There was no erythema, papules,
pustules or scarring of scalp. A detailed cutaneous examination revealed no café-au-lait
spots, ash leaf macules, axillary freckling or neurofibromas. The examination
of nails, mucosae and eyes was normal.
Investigations revealed normal hemogram, serum biochemistry, urine analysisand
a chest radiograph. Psychiatric evaluation revealed an average intelligence
(PQ 89, VQ 93) without any other abnormality. A skin biopsy showed hyperkeratosis,
acanthosis and a mild lymphomononuclear cell infiltrate with hypertrophy of
sebaceous glands.
