Postmenopausal Frontal Fibrosing Alopecia: Scarring Alopecia in a Pattern Distribution

The study examined six postmenopausal women who developed progressive frontal fibrosing alopecia, characterized by recession of the frontal hairline with perifollicular erythema and fibrosis. Scalp biopsies revealed lymphocytic inflammation, predominantly activated T-helper cells, around the follicles. Unlike typical lichen planopilaris, these women did not have mucous membrane or skin lesions, and hormonal studies showed no elevated androgen levels. The findings suggested that this form of alopecia might be a distinct reaction pattern associated with postmenopausal changes rather than a typical scarring alopecia like lichen planopilaris.