Cosmetic Dermatology and Hair Care

Lipedematous scalp (LS) is a condition in which there is localized accumulation of fatty tissue in the subcutaneous layer of the scalp without hair abnormalities. Clinically it is detected by palpation of the scalp exhibiting a localized soft and non-tender swelling. Currently, there is no effective treatment for LS but surgical treatment and oral mycophenolate mofetil were documented to be effective in LA. Here we report the first case in the medical literature of spontaneous resolution of lipedematous scalp in a patient whom we diagnosed and reported in 2004 to have Lipedematous scalp. A 69-year-old southern Arabic female presented to our dermatology clinic as a follow up case of lipedematous scalp diagnosed in our clinic in 2003. She is a known case of supraventricular tachycardia and hypercholesterolemia well controlled with medication. Besides, the patient scalp condition was last evaluated four years prior to her current visit in our clinic with no significant change. Interestingly, on examination of the scalp, there was absence of the spongy feeling on palpation and there was no loss of hair. Axial computed tomography of the skull showed scalp thickness in the high occipitoparietal region of 8 mm as compared to 21.1 mm in 2003. While midsagittal reconstructed computed tomography showed a scalp thickness at the high occipitoparietal region of 9 mm as compared to 16.9 mm in 2003. Subcutaneous fat thickness was almost 6 mm at the occipitoparietal region which is normal compared to 19.2 mm reported in 2003 for the same region. So, we confirmed our impression of spontaneous complete resolution of lipedematous scalp after thirteen years duration and it is the first reported case in the medical literature.