Postmenopausal Frontal Fibrosing Alopecia

The study examined six postmenopausal women who developed progressive frontal fibrosing alopecia, characterized by recession of the frontal hairline with perifollicular erythema and fibrosis extending to the temporal and parietal margins. Scalp biopsies revealed perifollicular fibrosis and lymphocytic inflammation, predominantly involving activated T-helper cells, similar to lichen planopilaris but without typical mucous membrane or skin lesions. Hormonal studies in five patients showed no elevated androgen levels. The findings suggested that this type of alopecia might be a distinct reaction pattern associated with postmenopausal changes rather than a form of lichen planopilaris.