Occult Giant Cell Arteritis Manifesting with a Scalp Ulcer

Giant cell arteritis (GCA) is a systemic inflammatory disorder of unknown etiology that affects medium and large sized arteries. It often presents with decreased vision or transient visual loss. Other typical manifestations include headache, jaw claudication, weight loss and scalp tenderness. Scalp ulceration in GCA is rare but may be a presenting sign and symptom. Elderly patients with new scalp ulcerations of no known etiology, even in the absence of other classic findings, should be evaluated for GCA.