A Novel Atypical Presentation of Frontal Fibrosing Alopecia Involving the Frontoparietal Scalp

    January 2020 in “ Skin appendage disorders
    Chloe Goldman, Aisleen Diaz, Mariya Miteva
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    TLDR A woman with an unusual pattern of hair loss was confirmed to have Frontal Fibrosing Alopecia and treated with specific medications.
    In 2020, a unique case of Frontal Fibrosing Alopecia (FFA) was documented in a 56-year-old woman who had been experiencing hair loss on the front and sides of her scalp for over a decade. The hair loss pattern was "upsilon"-shaped, extending into two symmetrical triangles along the parietal scalp, which is not typical for FFA. Trichoscopy revealed loss of follicular ostia and peripilar casts, and histology showed decreased follicular density and focal perifollicular fibrosis with a lichenoid infiltrate, confirming the FFA diagnosis. The patient was treated with topical tacrolimus 0.03% ointment and minoxidil 5% foam. This case underscored the importance of clinicians recognizing this unusual pattern, as it closely resembles traction alopecia.
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