Fibrosing Alopecia in a Pattern Distribution

December 2021 in “ Journal of The American Academy of Dermatology ”

Jacob Griggs, Ralph M. Trüeb, Maria Fernanda Reis Gavazzoni Dias, Maria Hordinsky, Antonella Tosti

fibrosing alopecia pattern distribution scarring alopecia androgenetic alopecia lichen planopilaris patterned hair thinning inflammation follicle miniaturization seborrheic dermatitis trichoscopy biopsy anti-inflammatory agents hair growth-promoting agents topical corticosteroids minoxidil oral hydroxychloroquine AGA LPP Rogaine

TLDR 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.

Fibrosing alopecia in a pattern distribution (FAPD) is a scarring alopecia that exhibits features of both androgenetic alopecia (AGA) and lichen planopilaris (LPP), affecting 188 patients (164 female, 24 male, average age 53.8) according to 15 articles reviewed. It is characterized by patterned hair thinning, inflammation, and follicle miniaturization, and is often misdiagnosed as AGA with seborrheic dermatitis. Diagnosis involves physical examination, trichoscopy, and a biopsy. Treatment options are limited and focus on anti-inflammatory and hair growth-promoting agents, with some success reported using topical corticosteroids, minoxidil, and oral hydroxychloroquine. Early recognition and treatment are crucial, but significant hair regrowth is not typically expected in advanced cases. Further research is needed to establish specific treatment guidelines.

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