F11 RED SCALP SYNDROME

Ramon Grimalt, Laura Lacueva, Gisela Hausmann, Juan Ferrando. Department of Dermatology, Hospital Clínic, University of Barcelona. Spain.

During routine hair exploration it is a common observation to see a peculiar reddish colour on the scalp of the studied patients. They are usually middle-aged females consulting for hair loss and it is sometimes associated to trychodinia.

The aim of our work was to investigate the red colour present on the scalp of these patients in order to discover its possible pathogenic role on the onset of the hair loss in them.

18 patients (14 females/4 males) with red scalp were included in the study. The age range was from 19 to 74 years. Clinical exploration, patch test, scalp biopsy and direct inmunofluorecence was performed.

Clinically most patients were low female androgenic alopecia (FAGA) from I-III Ebling, and the total evolution of the redness was from 2 months to 10 years. No other dermatological diseases were found to be associated in any of the patients. The patch test performed in 10 patients, showed positive results only in 3 cases (+ or ++) to fragrances and Ni but was probably not related with the clinical observation of the red scalp. Ten biopsies were performed, three were compatible with a cicatricial alopecia, three with FAGA and four were unspecific. In one of the last group, granular deposits of IgA and C3 were found in the basal membrane, in all the others the IF was negative. The scalp redness slowly tended to disappear with time.

The results found were not conclusive. The scalp redness  was associated with AGA in 13 out of 18 patients. An initial form of cicatricial alopecia should be considered but the tendency of the redness is to fad away. In conclusion we propose the terminology Red Scalp Syndrome to describe this peculiar entity that until now has not been well understood.