Fibrosing Alopecia in a Pattern Distribution Localized on Alopecia Androgenetica Areas and Unaffected Scalp
November 2004
in “
SKINmed Dermatology for the Clinician
”
fibrosing alopecia androgenetic alopecia follicular inflammatory lesions scleroatrophy vertex region follicular epithelium lymphohistiocytic perifollicular infiltrate follicular keratinocytes isthmus perifollicular lymphohistiocytes fibrotic sheath fibroblasts atrophic follicles pattern hair loss scarring alopecia
TLDR A man with hair loss developed a condition causing scarring and inflammation in both bald and non-bald areas of his scalp.
A 54-year-old man with a long history of androgenetic alopecia developed fibrosing alopecia in a pattern distribution, characterized by follicular inflammatory lesions leading to scleroatrophy in the vertex region. These lesions, which appeared over the course of a year, were found both in areas affected by androgenetic alopecia and unaffected scalp regions. Histopathologic examination revealed mild thinning of follicular epithelium, intense lymphohistiocytic perifollicular infiltrate, and degeneration of follicular keratinocytes, particularly under the isthmus. The inflammatory infiltrate was composed of perifollicular lymphohistiocytes, and a fibrotic sheath with fibroblasts formed around the atrophic follicles. Laboratory tests were negative for other conditions, confirming the diagnosis of fibrosing alopecia.
