Frontal Fibrosing Alopecia Involving the Limbs Shows Inflammatory Pattern on Histology: A Review of 13 Cases

    August 2019 in “ American Journal of Dermatopathology ”
    Mariya Miteva
    TLDR Frontal fibrosing alopecia on limbs shows permanent inflammatory hair loss, not typical scarring.
    This study reviewed 13 cases of frontal fibrosing alopecia (FFA) involving the limbs, revealing an inflammatory pattern characterized by lymphocytic folliculitis without perifollicular lamellar fibrosis, which is typically seen in scarring alopecia. The absence of perifollicular fibrosis and fibrotic tracts in limb biopsies could lead to misdiagnosis as alopecia areata, as these features are not present in the limb alopecia of FFA. The study highlighted that limb hair loss in FFA is inflammatory and permanent, differing from the classic scarring alopecia features. The findings suggest that the acute inflammation in FFA may have more severe effects on the shorter, faster-cycling follicles of the limbs compared to the terminal follicles of the scalp.
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