Alopecia mucinosa is a clinic-pathological entity which presents with several erythematous papules and plaques mainly over the head and face regions with associated loss of hair and histopathological findings of follicular mucinosis affecting most of the follicles.
Alopecia Mucinosa is caused by an abnormal accumulation of a normal substance, mucin, in hair bearing skin. For some unknown reason (thought to be related to our immune system) cells in the hair follicle produce an abnormal amount of mucin, causing a variety of skin lesions including hair loss and scarring.
The dermatologic eruptions consist of follicular papules and/or indurated plaques that demonstrate distinct histologic changes in the hair follicles that lead to hair loss. The accumulation of mucinous material in the damaged hair follicles and sebaceous glands creates an inflammatory condition and subsequent degenerative process. The face, the neck, and the scalp are the most frequently affected sites, although lesions may appear on any part of the body.
Alopecia mucinosa usually presents as slightly scaly bald patches in which the follicles are unusually prominent.
There are basically three types of alopecia mucinosa; a primary and acute disorder occurring in children and adolescents (Pinkus type), a primary and chronic disorder occurring in people older than 40 years and a secondary disorder associated with benign or malignant skin disease. Urticaria-like follicular mucinosis is very rare.
No proven cure exists for alopecia mucinosa, although several treatments are routinely used. Treatments include topical corticosteroids, ultraviolet A light (PUVA) therapy, topical nitrogen mustard and radiation therapy have demonstrated some success. Isolated cases document the beneficial responses of dapsone, indomethacin, and interferons. Because of the sporadic and recurrent nature of alopecia mucinosa, the effectiveness of one particular solution is difficult to prove.