Fibrosing Alopecia in a Pattern Distribution

February 2000 in “ Archives of dermatology ”

Martin Zinkernagel, Ralph M. Trüeb

fibrosing alopecia scarring alopecia lichen planopilaris pseudopelade follicular degeneration syndrome hair follicle miniaturization lichenoid inflammatory infiltrate perifollicular lamellar fibrosis fibrosed follicular tracts androgenetic alopecia scarring hair loss hair follicle shrinkage inflammatory infiltrate fibrous tissue around hair follicles fibrous hair tracts male pattern baldness

TLDR Some people with pattern hair loss may also have scalp inflammation and scarring similar to lichen planopilaris.

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.

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Research cited in this study

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research Postmenopausal Frontal Fibrosing Alopecia: A Frontal Variant of Lichen Planopilaris

329 citations, January 1997 in “Journal of the American Academy of Dermatology”

Frontal fibrosing alopecia is a hair loss condition in postmenopausal women, similar to lichen planopilaris, with ineffective treatments.

research Androgen Metabolism as It Affects Hair Growth in Androgenetic Alopecia

143 citations, October 1996 in “Dermatologic Clinics”

Too much androgen can cause hair loss; finasteride may help.

research Diagnostic and Predictive Value of Horizontal Sections of Scalp Biopsy Specimens in Male Pattern Androgenetic Alopecia

309 citations, May 1993 in “Journal of The American Academy of Dermatology”

Horizontal scalp biopsy sections effectively diagnose and predict MPAA, with follicular density and inflammation impacting hair regrowth.

research The Transverse Anatomy of Androgenic Alopecia

42 citations, December 1990 in “The Journal of Dermatologic Surgery and Oncology”

The study found that horizontal sections of scalp biopsies are better for analyzing hair loss, showing fewer hairs and more fine hairs in balding areas.

research Androgenetic Alopecia: Clinical Aspects and Treatment

19 citations, January 1990 in “Springer eBooks”

research Male Pattern Alopecia: A Histopathologic and Histochemical Study

94 citations, August 1975 in “Journal of Cutaneous Pathology”

Male pattern baldness involves smaller hair follicles, larger oil glands, and other tissue changes, but not major blood supply issues.

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