Cicatricial alopecia presents a diagnostic challenge to clinicians. In particular, lesions of cutaneous sarcoidosis of the scalp may resemble discoid lupus erythematosus (DLE). We report two cases of sarcoidal alopecia originally thought to represent DLE scarring plaques of the scalp. A subsequent histopathologic diagnosis of sarcoidal alopecia was made. These cases highlight the importance of making the correct diagnosis of sarcoidal alopecia versus DLE so that a patient can receive the correct work-up and definitive treatment. These cases illustrate the fact that there should be a low threshold for biopsy of cicatricial plaques on the scalp.
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