26-year-old Vietnamese woman diagnosed with rare combination of hair loss and scalp nevus

A 26-year-old woman in Ho Chi Minh City faces a distressing medical mystery as she suffers from extreme hair loss, shedding hundreds of strands daily, and has been diagnosed with a rare combination of conditions: frontal fibrosing alopecia and a giant blue nevus on her scalp. Doctors at the University Medical Center of Ho Chi Minh City describe the simultaneous presence of these two conditions as unprecedented in global medical literature.

The patient, identified as T.N.T., reported that her hair loss started about five months ago, accompanied by persistent itching. The shedding initially began at the back of her head, gradually spreading to her forehead and temples. In the past month, the condition has worsened dramatically, with rapid loss of her eyebrows and the appearance of small bumps around hair follicles on her face and the back of her neck.

She has had a blue-colored patch on her scalp since birth, identified as a giant blue nevus, which had remained stable for years. However, hair in this area grew thicker but included many prematurely gray strands. Previous treatments for what was diagnosed as patchy hair loss at a dermatology clinic proved ineffective, leading her to seek specialized care.

Medical examinations revealed typical signs of scarring alopecia, including a smooth, hairless scalp, particularly on her forehead and temples, causing her hairline to recede. Similar lesions were observed at the back of her head. A scalp biopsy was performed, and initial results were sent to the United States for further analysis. The final diagnosis confirmed frontal fibrosing alopecia, a rare form of scarring hair loss that can lead to permanent baldness if not treated promptly.

Doctors emphasize the importance of early diagnosis for conditions like persistent scalp itching, unusual hair loss, receding hairlines, or unexplained eyebrow loss. The unique case, combining frontal fibrosing alopecia with a giant blue nevus, presents a significant challenge and an opportunity for further medical research.

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Oh my! What is that?