Cicatricial Alopecia with Particular Trichoscopic and Histopathological Features

    November 2018 in “ Skin appendage disorders ”
    Helena Rocchetto, Carolina Oliveira Costa Fechine, Alessandra Anzai, Andréia Munck, Adriana Rochetto Assalin, Neusa Yuriko Sakai Valente, Ricardo Romiti
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    TLDR The document concludes that a woman has both Frontal Fibrosing Alopecia and Lichen Simplex Chronicus, a previously unreported combination of conditions.
    The document discusses a case of a 69-year-old woman with a 3-year history of hair and eyebrow loss, severe itching, and constant scratching of the scalp. Physical examination showed eyebrow absence, frontal hairline recession, thick skin in the frontoparietal area, and short broken hairs. Trichoscopic findings included the absence of vellus hairs and follicular openings, perifollicular scaling, and broom hair fibers. Histopathology revealed hyperkeratosis, acanthosis, mild papillomatosis, perifollicular fibrosis, and mild lymphoplasmacytic infiltrate around the isthmus. The diagnosis was an association of Frontal Fibrosing Alopecia (FFA) and Lichen Simplex Chronicus (LSC). FFA is a primary lymphocytic scarring alopecia with progressive frontotemporal hairline recession, while LSC is a skin disease characterized by lichenified patches due to constant scratching. The coexistence of both conditions in the same patient had not been reported before this case. The trichoscopic and histopathological findings supported the diagnosis of both conditions.
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      community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

      in Research  830 upvotes 7 months ago
      Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

      community Totally confused by doctors opinions, would appreciate some clarity

      in Treatment  1 upvotes 3 months ago
      The user is experiencing hair loss and confusion over conflicting medical advice, with treatments including minoxidil, finasteride, and topical corticosteroids. They are unsure about the necessity of a biopsy and the timing of using minoxidil, while also considering the impact of potential androgenetic alopecia and telogen effluvium.

      community I am a dermatologist with a clinical interest in alopecia. AMA

      in Will treatment work for me? 2 years ago
      In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

      community Losing Hair on Dutasteride? You might have LPP

      in Research/Science  94 upvotes 4 weeks ago
      Men with hair loss might have lichen planopilaris (LPP), which can mimic androgenetic alopecia, leading to misdiagnosis and ineffective treatment with finasteride or dutasteride. Proper diagnosis, including biopsies, is crucial to distinguish between androgenetic alopecia and conditions like LPP.

      community You will lose hair if your prostaglandins aren't in balance

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