IgG4-related disease presenting with scarring alopecia of the scalp

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IgG4-related disease presenting with scarring alopecia of the scalp Paul M. Hoesly, MD, Jason C. Sluzevich, MD JAAD Case Reports Volume 4, Issue 6, Pages 555-557 (July 2018) DOI: 10.1016/j.jdcr.2018.03.002 Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Tumefactive alopecic plaque involving the right temporal scalp. JAAD Case Reports 2018 4, 555-557DOI: (10.1016/j.jdcr.2018.03.002) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Smooth nodule on the left mandible. JAAD Case Reports 2018 4, 555-557DOI: (10.1016/j.jdcr.2018.03.002) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Punch biopsy specimen from the right temporal scalp. The 4-mm biopsy shows a diffuse dermal histiocytic infiltrate with dense lymphoplasmacytic inflammation, perifollicular fibrosis, and follicular effacement. (Hematoxylin-eosin stain; original magnification: ×2.) JAAD Case Reports 2018 4, 555-557DOI: (10.1016/j.jdcr.2018.03.002) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 4 Tumefactive alopecic plaque. This view highlights numerous plasma cells. (Hematoxylin-eosin stain; original magnification: ×40.) JAAD Case Reports 2018 4, 555-557DOI: (10.1016/j.jdcr.2018.03.002) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions

Fig 5 Immunostains of infiltrate. A, Immunostain shows an infiltrate rich in IgG4+ plasma cells. The infiltrate had an IgG4+ cell count of 80 per HPF and an IgG4+/IgG+ ratio of 80%. B, IgG immunostain shown for comparison. (A and B, original magnifications: ×20.) JAAD Case Reports 2018 4, 555-557DOI: (10.1016/j.jdcr.2018.03.002) Copyright © 2018 American Academy of Dermatology, Inc. Terms and Conditions