Alopecia neoplastica without alopecia: a unique presentation of breast carcinoma scalp metastasis.

The scalp is a relatively common site of cutaneous metastasis. The usual presentation is of single or multiple firm scalp nodules. A well-recognized but rarer presentation is alopecia neoplastica that is seen as single or multiple areas of cicatricial alopecia. We describe a unique presentation of scalp metastasis in a patient with breast carcinoma in whom hair loss was clinically inconspicuous. The metastasis responded to combination chemotherapy.