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The patient had a personal history of polymyalgia rheumatica diagnosed in 2014, for which he required treatment with systemic corticosteroids for one year.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed 2 ulcerated lesions in the left fronto-parietal location and one in the right parietal, with non-inflammatory and non-indurated margins (<a class="elsevierStyleCrossRef" href="#fig0005">Figs. 1</a>A and B). No temporal pulses were palpable. The history taking revealed no jaw claudication or visual impairment.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">With a diagnostic approach to giant cell arteritis (GCA), a blood test showed an increase in ESR (51 mm), and a temporal artery biopsy confirmed the diagnosis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Treatment was started with prednisone 1 mg/kg/day for one month and a subsequent tapering regimen, achieving complete re-epithelialisation of all lesions by the eighth week of treatment (<a class="elsevierStyleCrossRef" href="#fig0005">Figs. 1</a>C and D).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Scalp necrosis secondary to giant cell arteritis is a rare presentation that involves advanced disease. It is important to be aware of this form of presentation and to have a high level of suspicion for early diagnosis and treatment.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">This research has not received specific grants from public or private agencies or from non-profit entities.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Bauer-Alonso A, Llobera-Ris C, Llatjós R, Bonfill-Ortí M. Úlceras bilaterales en cuero cabelludo. Med Clin (Barc). 2021;157:599.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 960 "Ancho" => 1425 "Tamanyo" => 321064 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 542 "Ancho" => 1425 "Tamanyo" => 260516 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015700000012/v1_202112201710/S2387020621006501/v1_202112201710/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015700000012/v1_202112201710/S2387020621006501/v1_202112201710/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020621006501?idApp=UINPBA00004N" ]
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