TLDR A woman's progressive hair loss was correctly diagnosed as a rare condition called fibrosing alopecia in a pattern distribution after initially being mistaken for a more common type.
The document is a case report of a 34-year-old female patient with a 4-year history of progressive hair loss, initially misdiagnosed as androgenetic alopecia (AGA). After further examination and a trichoscopy-guided biopsy, the patient was diagnosed with fibrosing alopecia in a pattern distribution (FAPD), a rare form of lymphocytic primary cicatricial alopecia. FAPD is characterized by clinical and histopathological features of both lichen planopilaris (LPP) and AGA. The patient was treated with intralesional injections of triamcinolone acetonide 20 mg/mL every month and twice daily applications of minoxidil 2% during the follow-up period. The report emphasizes that FAPD can be easily misdiagnosed as AGA and highlights the importance of dermoscopy for early diagnosis and selecting the optimum site for biopsy. The pathophysiology of FAPD is not well known, but it is thought to be a T-cell-mediated autoimmune reaction associated with apoptosis of follicular epithelial cells. Treatment options for FAPD are limited and further studies are needed to evaluate their potential effectiveness.
30 citations,
January 2020 in “Journal of The American Academy of Dermatology” Fibrosing alopecia in a pattern distribution is a hair loss condition often confused with other types, requiring early treatment but usually not resulting in significant hair regrowth.
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A 21-year-old with lichen planopilaris was successfully treated, stopping disease progression and preventing crusts.
