Dermatopathology Quiz: Which Alopecia Does the Patient Have?

A 60-year-old woman with bilateral hair loss of the anterior frontoparietal hairline was diagnosed with frontal fibrosing alopecia (FFA) based on histopathological analysis showing superficial dermal fibrosis and peri-infundibular lymphoid infiltrate. FFA, a cicatricial alopecia variant of lichen planopilaris, is characterized by gradual, asymptomatic hair loss in a symmetrical pattern, often seen in postmenopausal women. Histological findings include reduced terminal hair follicles replaced by fibrous tracts and a lymphocytic infiltrate at the isthmus and infundibulum. Treatment options include hormonal treatments, steroids, pioglitazone, antimalarials, and retinoids, with oral dutasteride showing efficacy in about half of the patients.