Fibrosing Alopecia in a Pattern Distribution

January 2019 in “ Elsevier eBooks ”

Ralph M. Trüeb, Maria Fernanda Reis Gavazzoni Dias

TLDR FAPD and possibly CCCA may be AGA subtypes, and treatments combining antiandrogens, hair growth agents, hair transplants, and anti-inflammatories could be effective.

The document from 2019 discusses Fibrosing Alopecia in a Pattern Distribution (FAPD), a type of scarring alopecia that presents similarly to Androgenetic Alopecia (AGA) but includes a lichenoid tissue reaction. AGA treatments like antiandrogens, 5a-reductase inhibitors, and minoxidil have limited success, suggesting that follicular inflammation and fibrosis may play a role in the condition. FAPD is characterized by histopathologic features of lichen planopilaris (LPP) and may coexist with Frontal Fibrosing Alopecia (FFA), with an autoimmune pathogenesis suggested for these conditions. The document also covers Central Centrifugal Cicatricial Alopecia (CCCA), which predominantly affects women of African origin and is associated with type 2 diabetes, bacterial scalp infections, and certain hairstyles. The study by Kyei et al. is referenced, but the number of participants is not mentioned. The conclusion is that FAPD and possibly CCCA should be considered subtypes of AGA, and that combined treatments including antiandrogens, hair growth agents, hair transplantation, and anti-inflammatory treatments may be effective for these conditions.

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