Differential Diagnosis of Female-Pattern Hair Loss

The article discusses the case of a 45-year-old woman with diffuse hair loss and thinning, and the differential diagnosis of female-pattern hair loss. The possible diagnoses include androgenetic alopecia, telogen effluvium, cicatricial alopecia, and alopecia areata incognita (AAI). Dermoscopy and histopathology are important tools in confirming the diagnosis of AAI, which is characterized by diffuse hair loss that mimics telogen effluvium and androgenetic alopecia. The article also discusses the histopathologic features of AAI, which include a nonscarring pattern with an increased number of telogen follicles and vellus/miniaturized follicles, dilated infundibular openings plugged with keratin and sebum, and an inflammatory infiltrate around the miniaturized follicles in the upper dermis. Treatment for AAI typically involves systemic or topical steroids, and the article emphasizes the importance of using dermoscopy and histopathology to confirm the diagnosis and prescribe appropriate treatment.