Bald patch needs a closer look

This bald scalp area may at first appear to be alopecia areata, an autoimmune disease that attacks hair follicles. However, the redness of the skin makes this less likely, as the inflammation in alopecia areata is generally very mild. Also, in alopecia areata the openings of the hair follicles are preserved, unlike here where they have been destroyed. This is a scarring alopecia due to discoid lupus erythematosus. DLE usually involves the face and other sun-exposed areas but sometimes the scalp is primarily involved. This is a scarring disorder and hence the hair is lost forever, so it is important to treat quickly with strong topical or intralesional corticosteroid.