This patient had undiagnosed CCCA (Central Centrifugal Cicatricial Alopecia) for years by the time she came to see me. I did a biopsy to confirm my suspicions, and the pathology results were consistent with CCCA. She was treated with intralesional steroids and Hydroxychloroquine.
https://www.htandrc.com/gallery/womens-photo-gallery/patient-07.html#sigProId6d4ac2fd2a