PMC5056910_01
a Clinical manifestation showing alopecia accompanied by thickened scalp. b CT scan showing thickening scalp with marked expansion of subcutaneous adipose tissue approximately 15 mm in the occipital region
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PMC5056910_01_40064_2016_3430_Fig1_HTML.jpg
Fig1
Physical examination revealed alopecia of the entire scalp and the remaining hair was short and less than 2 cm, as shown in Fig. 1a. Computer tomography (CT) scan demonstrated diffuse thickening of the subcutaneous tissues in the occipital region, which was measured as approximately 15 mm (Fig. 1b). 
a H&E staining revealing mild perivascular mononuclear infiltration into the superficial dermis and increased subcutaneous adipose tissue (x100 magnification). b H&E staining showing perifollicular fibrosis (x400 magnification). c H&E staining revealing disruption of adipocytes (x400 magnification). d Alcian blue staining showing mucin deposition in the dermis (x400 magnification)
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PMC5056910_01_40064_2016_3430_Fig2_HTML.jpg
Fig2
Skin biopsy showed increased subcutaneous adipose tissue and mild perivascular mononuclear infiltration into the superficial dermis (Fig. 2a). Scant perifollicular mononuclear infiltration accompanied by perifollicular fibrosis was equally observed in Fig. 2b. Adipocyte disruption and mucin deposition were also demonstrated, as illustrated in Fig. 2c, d. 