Peculiar Hypertrichosis in a Patient Affected by Frontal Fibrosing Alopecia with Pseudo Fringe Sign

A 60-year-old female with frontal fibrosing alopecia (FFA) exhibited a unique case of hypertrichosis after 6 months of treatment with a topical lotion containing 2% minoxidil, 0.08% hydrocortisone butyrate, and 0.05% 17a-estradiol. The patient showed increased hair growth at the anterior margins of the frontotemporal scarring band, with some terminal hairs present in the scarring area. This pattern of hypertrichosis, characterized by vellus-like hair adjacent to the alopecic area and terminal hair within the scarring band, had not been previously reported in FFA patients. The study suggested that minoxidil-induced hair growth might affect only non-affected adjacent hair follicles due to the irreversible replacement of vellus-like hair follicles by fibrosis in the affected area. Further research was recommended to better understand the pathophysiological mechanisms of FFA and develop effective treatments.