Dermatology: Practical and Conceptual


Image Letter | Dermatol Pract Concept. 2022;12(3):e2022112 1

Dermatology Practical & Conceptual

Perinevoid Alopecia: an Unusual Presentation  
of Alopecia Areata

José Leonardo Rodrigues Machado1, Rita Fernanda Cortez de Almeida2,  
Simone Carolina Frattini3, Daniel Fernandes Melo2 

1 Dermatology Department, Faculdade IPEMED de Ciências Médicas (AFYA), Rio de Janeiro, Brazil

2 Dermatology Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil

3 Mental Health Department, Guelph General Hospital, Guelph, Ontario, Canada

Citation: Machado JLR, Cortez de Almeida RF, Frattini SC, Melo DF. Perinevoid alopecia: an unusual presentation of alopecia areata. 
Dermatol Pract Concept. 2022;12(3):e2022112. DOI: https://doi.org/10.5826/dpc.1203a112

Accepted: November 12, 2021; Published: July 2022

Copyright: ©2022 Machado et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, 
distribution, and reproduction in any medium, provided the original authors and source are credited.

Funding: None.

Competing interests: None.

Authorship: All authors have contributed significantly to this publication

Corresponding author: Daniel Fernandes Melo, MSc MD, Address: Estrada dos Tres Rios 1200 – office 810 – Zip code 22745-052 Email 
address: danielfernandesmelo@yahoo.com.br

Case Presentation 

A 19-year-old healthy male complained of sudden onset 

of asymptomatic single patch alopecia on the occiput 

for three months. The round patch of non-scarring alo-

pecia surrounded a pre-existent pigmented dome-shaped 

compound nevus, which did not change over time  

(Figure 1). Trichoscopic features were compatible with al-

opecia areata (AA), and the patient decided on conserva-

tive management.

Teaching point

Perinevoid alopecia (PA) is an extremely rare variant of AA 

associated with a central generally pigmented nevus [1]. Al-

though the pathogenesis is still unclear, it is thought that PA 

is secondary to an inflammatory response against nevus cells 

or melanocytic structures [1,2]. Immune cells around the ne-

vus attack the hair follicle, similarly to the destruction of me-

lanocytes in a halo nevus, other nevocentric phenomena [2].   

Surgical removal of the nevus may lead to hair regrowth a 

Figure 1. A 1-cm diameter round patch of non-scarring alopecia 

surrounding a pre-existent pigmented dome-shaped compound sub-

type nevus on the right side of the occiput.



2 Image Letter | Dermatol Pract Concept. 2022;12(3):e2022112

few weeks after excision [1,2]. Recognizing PA is essential to 

properly manage this unique variant of AA.

References

1. Kimura H, Nagase K, Narisawa Y. Perinevoid alopecia: a case re-

port and literature review. Br J Dermatol. 2018;179(4):969-970. 

DOIi:10.1111/bjd.16709. MID: 29704462.

2. Ruiz-Arriaga LF, López-García L, Vega-Memije ME. Perinevoid 

Alopecia: A Case Report. Skin Appendage Disord. 2019;5(2): 

94-96. DOI:10.1159/000490469. PMID: 30815441. PMCID: 

PMC6388562.\