Fibrosing Alopecia in a Pattern Distribution

The study examined 19 patients (15 women and 4 men) with progressive scarring alopecia in a pattern distribution, comparing their clinical and histological findings to those of other scalp scarring conditions like lichen planopilaris, pseudopelade, and follicular degeneration syndrome. The patients showed symptoms of fibrosing alopecia in the central scalp, distinct from the multifocal involvement seen in the other conditions. Early biopsy specimens revealed hair follicle miniaturization and a lichenoid inflammatory infiltrate targeting the upper follicle, while advanced lesions exhibited perifollicular lamellar fibrosis and fibrosed follicular tracts. The study suggested that some individuals with androgenetic alopecia may also have inflammation and fibrosis confined to the area of hair loss, with early histological signs similar to lichen planopilaris, indicating a possible pathogenetic link between the two conditions.