Graft Versus Host Disease Presenting as Fibrosing Alopecia in a Pattern Distribution: A Model for Pathophysiological Understanding of Cicatricial Pattern Hair Loss

January 2018 in “ International Journal of Trichology ”

Hudson Dutra Rezende, Maria Fernanda Reis Gavazzoni Dias, Ralph M. Trüeb

graft versus host disease fibrosing alopecia pattern distribution cicatricial pattern hair loss inflammation fibrosis minoxidil triamcinolone acetonide lichen planus lichen planopilaris GVHD FAPD Rogaine

From the encyclopedia

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Triamcinolone Acetonide →

Studysummary This case report discusses cutaneous graft versus host disease presenting as fibrosing alopecia, suggesting a mechanistic model for understanding cicatricial pattern hair loss.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

In 2018, a case study was conducted on a 58-year-old woman with graft versus host disease (GVHD) and acute myeloid leukemia, who developed fibrosing alopecia in a pattern distribution (FAPD), a type of hair loss. The study suggested that the inflammation and fibrosis caused by GVHD led to FAPD, providing a model for understanding the pathophysiology of cicatricial pattern hair loss. The woman was treated with a compound of 5% minoxidil and 0.2% triamcinolone acetonide. This case study highlighted GVHD as a potential immunologic model for understanding other hair loss conditions like lichen planus and lichen planopilaris.

View this study on journals.lww.com →

Discuss this study in the Community →

Research cited in this study

20 / 20 results

research Clinical and Histological Study of Permanent Alopecia After Bone Marrow Transplantation

23 citations , December 2015 in “Anais Brasileiros de Dermatologia”

This study identified two distinct histological patterns in permanent alopecia following bone marrow transplantation, suggesting links to myeloablative chemotherapy and chronic graft-versus-host disease.

research Nail Involvement in Frontal Fibrosing Alopecia

17 citations , January 2015 in “International Journal of Trichology”

This case report suggests that frontal fibrosing alopecia with nail involvement may be associated with lichen planus and improved with oral dutasteride due to an inflammatory reaction related to androgenetic alopecia.

research Frontal Fibrosing Alopecia: A Retrospective Clinical Review of 62 Patients with Treatment Outcome and Long-Term Follow-Up

102 citations , April 2014 in “International Journal of Dermatology”

This study found that early intervention and treatment with intralesional triamcinolone acetonide may stabilize hairline recession in patients with frontal fibrosing alopecia, although further research is needed for definitive treatment guidelines.

research Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients

339 citations , February 2014 in “Journal of The American Academy of Dermatology”

This study found that eyelash loss, facial papules, and body hair involvement were linked to severe frontal fibrosing alopecia, and antiandrogens were the most effective treatment.

research Lichen Planopilaris Is Characterized By Immune Privilege Collapse Of The Hair Follicle's Epithelial Stem Cell Niche

220 citations , June 2013 in “The Journal of Pathology”

This study found that immune privilege collapse in the hair follicle bulge and associated immune responses may contribute significantly to the pathogenesis of lichen planopilaris, suggesting a potential autoimmune basis for the disease.

research Discoid Lupus Alopecia Complicated by Frontal Fibrosing Alopecia on a Background of Androgenetic Alopecia

25 citations , March 2013 in “British Journal of Dermatology”

Woman has discoid lupus, frontal fibrosing, and androgenetic alopecia.

research Frontal Fibrosing Alopecia: A Retrospective Review of 19 Patients Seen at Duke University

98 citations , January 2013 in “Journal of The American Academy of Dermatology”

This study reported that while various treatments for frontal fibrosing alopecia showed limited effectiveness, dutasteride most effectively stabilized the condition among patients at Duke University.

research Frontal Fibrosing Alopecia: A Review of 60 Cases

166 citations , April 2012 in “Journal of The American Academy of Dermatology”

This study reviewed clinical data from 60 patients with frontal fibrosing alopecia and found increasing prevalence and generally poor response to treatment, with the cause remaining unclear.

research Value of Trichoscopy Versus Trichogram for Diagnosis of Female Androgenetic Alopecia

45 citations , January 2012 in “International Journal of Trichology”

This study reported that trichoscopy is a more effective diagnostic tool than the trichogram for early diagnosis of FAGA, regardless of hair shaft diversity cut-off levels.

research Frontal Fibrosing Alopecia: A Clinical Review of 36 Patients

159 citations , August 2010 in “British journal of dermatology/British journal of dermatology, Supplement”

In this study, hydroxychloroquine significantly reduced signs and symptoms of frontal fibrosing alopecia after 6 months of treatment, with maximal benefits observed within the first 6 months.

research Anisotrichosis: A Novel Term to Describe Pattern Alopecia

25 citations , April 2007 in “Journal of The American Academy of Dermatology”

This article introduces the term "anisotrichosis" to describe the significant variation in hair shaft diameters observed in pattern alopecia, drawing a parallel to anisocytosis seen in blood smears, but reports no new research findings.

research Female Pattern Hair Loss and Its Relationship to Permanent/Cicatricial Alopecia: A New Perspective

73 citations , November 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

This article reviews the potential relationship between different forms of permanent hair loss such as cicatricial pattern hair loss and discusses related conditions, reporting no new clinical findings.

research Hair Diameter Diversity: A Clinical Sign Reflecting Follicle Miniaturization

41 citations , May 2001 in “PubMed”

This study proposes a new clinical scoring method for hair density based on hair diameter diversity, which correlates with existing measures and reflects follicle miniaturization in androgenetic alopecia.

research Androgenetic Alopecia and Microinflammation

131 citations , August 2000 in “International Journal of Dermatology”

Inflammation may be linked to hair loss, and targeting specific enzymes could help treat it.

research Fibrosing Alopecia in a Pattern Distribution

158 citations , February 2000 in “Archives of dermatology”

This study reports that some patients with androgenetic alopecia may also exhibit clinical and histological features of inflammation and fibrosis, similar to those found in lichen planopilaris.

research Treatment of Hair Loss

370 citations , September 1999 in “The New England Journal of Medicine”

This article discusses the treatment of androgenetic alopecia and alopecia areata with finasteride and minoxidil but reports no new clinical results.

research The Biology of Hair Follicles

1113 citations , August 1999 in “The New England Journal of Medicine”

This article discusses the biologic and psychosocial significance of hair, the current limitations in hair growth drugs, and anticipates future therapies based on advancing hair follicle research.

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

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

This study reports that progressive frontal fibrosing alopecia, a distinct and gradually stabilizing form of lichen planopilaris affecting elderly women and often involving eyebrow hair loss, lacks effective treatments.

research Postmenopausal Frontal Fibrosing Alopecia: Scarring Alopecia in a Pattern Distribution

332 citations , June 1994 in “Archives of Dermatology”

This study found that progressive frontal hairline recession in postmenopausal women may exhibit features similar to fibrosing alopecia, with histologic similarities to lichen planopilaris but lacking lesions of lichen planus.

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”

This study concluded that horizontal sections of scalp biopsy specimens provide more diagnostic information for male pattern androgenetic alopecia than vertical sections and can predict hair regrowth potential following topical minoxidil therapy.