Fibrosing Alopecia in a Pattern Distribution

Zinkernagel, Martin; Trüeb, Ralph M.

doi:10.1001/archderm.136.2.205

Cited by 162 publications

(90 citation statements)

References 21 publications

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“…FAPD in Caucasians was first described by Zinkernagel and Trüeb [1] as a type of cicatricial pattern alopecia with histopathological features consistent with AGA, lichen planopilaris, and frontal fibrosing alopecia (FFA) [9-11]. The authors described patients with FAPD with clinical features of AGA [9] and cicatricial findings, some of them presenting with the involvement of the frontal hair line [1, 12, 13].…”

Section: Discussionmentioning

confidence: 99%

“…Biopsies were dermoscopy guided. The optimal site for biopsy presented perifollicular erythema and scaling, keratotic follicular plugging, and/or a peripilar gray-whitish halo [1, 7]. Specimens were transvertionally sectioned two times to study three different levels: the first level at 1 mm below the epidermis (infundibulum), the second level at 1 mm below the first one (isthmus), and a third level (suprabulbar) [2, 8].…”

Section: Methodsmentioning

confidence: 99%

“…Fibrosing alopecia in a pattern distribution (FAPD) is a form of cicatricial pattern alopecia described in 2000 by Zinkernagel and Trüeb [1] as a possible variant of the lymphocytic primary cicatricial alopecia group [1]. The hallmark of this type of alopecia is the combination of clinical and histopathological features of lichen planopilaris and androgenetic alopecia (AGA) [1-6].…”

Section: Introductionmentioning

confidence: 99%

“…The hallmark of this type of alopecia is the combination of clinical and histopathological features of lichen planopilaris and androgenetic alopecia (AGA) [1-6]. Since the first description of FAPD only included Caucasians, the study of this condition in patients of color needs to be revisited.…”

Section: Introductionmentioning

confidence: 99%

“…Since the first description of FAPD only included Caucasians, the study of this condition in patients of color needs to be revisited. We present 12 African-descent and 4 Hispanic Brazilian female patients with progressive scarring alopecia in a male or female pattern distribution and analyze the clinical, dermatoscopic, and histopathologic features of the condition [1, 2]. …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Fibrosing Alopecia in a Pattern Distribution (FAPD) in 16 African-Descent and Hispanic Female Patients: A Challenging Diagnosis

Teixeira

Dias

Trüeb³

et al. 2019

Skin Appendage Disord

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Background: Fibrosing alopecia in a pattern distribution (FAPD) has only been described in Caucasian patients, and it is not clear whether it can develop in dark-skin ethnicities. Materials and Methods: Sixteen Brazilian female patients, 12 of African descent and 4 Hispanic, with progressive scarring alopecia in a pattern distribution were analyzed. Results: Dermatoscopic features showed perifollicular erythema and scaling (14/16), hair fiber diameter diversity (16/16), loss of follicular ostia (16/16), and follicular keratosis (3/16). Late stages showed a honeycomb pigmented network (12/16), a hyperpigmented perifollicular halo (12/16), and small white patches (12/16). Histopathological features showed lichenoid perifollicular infiltrate (14/16), follicular miniaturization (16/16), concentric fibrosis (16/16), perifollicular lymphocytic infiltrate (16/16), and vellus hair involvement (10/16). Premature desquamation of the inner root sheath was found in 11 patients. Conclusions: The concomitant findings of cicatricial pattern hair loss (with or without the recess of the front hair line), hair fiber diversity, perifollicular erythema and scaling, a whitish perifollicular halo, and histological findings of androgenetic alopecia, with vacuolar interface alteration of the upper portion of the follicular epithelium, are the main key features to suggest the diagnosis of FAPD. FAPD is a possible diagnosis in patients of color with cicatricial pattern hair loss. Clinical, dermatoscopic, and histopathological examination allow a proper final differential diagnosis.

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