Background
In 1888, Brocq used the term pseudopelade to describe a unique form of cicatricial alopecia resembling alopecia areata (pelade is the French term for alopecia areata).
Over the last century, this condition has been a source of controversy.
While some believe pseudopelade is a unique entity, most now believe that it is an end stage or clinical variant of various forms of cicatricial alopecia.
The same pattern of alopecia can be found in end-stage discoid lupus erythematosus (DLE), lichen planopilaris (LLP), and other forms of cicatricial alopecia. The confusion is further amplified by a difference in definition between different countries. For example, in Germany, all types of inflammatory cicatricial alopecia are included in the grouping of pseudopelade. In contrast, American dermatologists have used the term as a diagnosis of exclusion.
Pseudopelade of Brocq is not a specific disease, but a pattern of cicatricial alopecia.
If a definitive diagnosis of DLE, LLP, or another condition can be made based on clinical, histological, or immunofluorescent features, then the term pseudopelade of Brocq cannot be used. A primary form of traditional pseudopelade may exist, but this has yet to be established with certainty.