The Follicular Degeneration Syndrome in Black Patients

Sperling, Leonard C.

doi:10.1001/archderm.1992.01680110078010

Cited by 145 publications

(84 citation statements)

References 5 publications

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“…Until now, FAPD is not considered to exist in patients of color in whom CCCA is a mainstream diagnosis for mid-scalp cicatricial alopecia [17, 18]. Mardones et al [4] were the first to describe the evidence of FAPD amongst Latin Americans in Chile.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%

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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“…10 Cases are classified as lymphocytic, neutrophilic or mixed (Table 1). 5,6,9,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] In end-stage disease, in which the infiltrate is no longer detectible, the condition is said to be "burned out," and no further classification is possible.…”

Section: How Is Primary Cicatricial Alopecia Classified?mentioning

confidence: 99%

Primary cicatricial alopecia: diagnosis and treatment

Filbrandt

Rufaut

Jones

et al. 2013

CMAJ

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Review CMAJ• Inflammation that destroys the bulge of the outer root sheath destroys the hair follicle and leads to cicatricial alopecia.• Primary cicatricial alopecia is an inflammatory disorder of unknown cause that leads to irreversible hair loss.• The natural history is for the alopecia to extend slowly over the scalp and eventually burn out. The rate of extension and the final severity are extremely variable and difficult to predict.• A number of treatments are used empirically; however, they are not supported by data from clinical trials.

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“…11,12 The histological findings of advanced lesions in our patients share features with the recently described follicular degeneration syndrome observed in black patients. 13,14 Also, the clinical presentation of these black women might mimic female pattern AGA because it pro- duces frontovertical alopecia. 13 The earliest observable histological abnormalities considered distinctive of this disorder are premature degeneration of the inner root sheath and migration of the hair shaft through the outer root sheath, 13 whereas the follicular interface dermatitis present in most of our patients is not a feature.…”

Section: Commentmentioning

confidence: 99%