Clinicopathological Characteristics and Treatment Outcomes of Fibrosing Alopecia in a Pattern Distribution: A Retrospective Cohort Study

    August 2021 in “ Journal of the European Academy of Dermatology and Venereology ”
    Rebekka Jerjen, Joel Pinczewski, Rodney Sinclair, Bevin Bhoyrul
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    TLDR Early treatment of fibrosing alopecia in a pattern distribution may improve outcomes.
    The retrospective cohort study focused on 24 female patients with fibrosing alopecia in a pattern distribution (FAPD), a subtype of lichen planopilaris (LPP), with a mean age of 60.7 years and a median Sinclair grade of 3 for hair loss severity. Trichoscopic features included hair shaft diameter variability (100%), perifollicular erythema and/or scaling (95%), and loss of follicular ostia (95%). Histopathology showed scarring alopecia with interface changes. Treatments such as corticosteroids, 5α-reductase inhibitors, and hydroxychloroquine arrested disease progression in 14 patients and resulted in hair regrowth in 2 patients, but 6 patients experienced progression despite treatment. The study concluded that early treatment could lead to more favorable outcomes, though it acknowledged limitations such as small sample size and retrospective design. The study suggests that a combination of anti-inflammatory and hair growth-promoting agents may be beneficial, and emphasizes the need for early diagnosis and intervention.
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