Fibrosing alopecia in a pattern distribution.

FAPD androgenetic alopecia central centrifugal cicatricial alopecia cicatricial alopecia fibrosing alopecia in a pattern distribution frontal fibrosing alopecia lichen planopilaris scarring alopecia

Journal

Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132

Informations de publication

Date de publication:
12 2021
Historique:
received: 04 09 2019
revised: 23 12 2019
accepted: 25 12 2019
pubmed: 12 1 2020
medline: 2 4 2022
entrez: 12 1 2020
Statut: ppublish

Résumé

Fibrosing alopecia in a pattern distribution (FAPD) is a newly recognized form of scarring alopecia sharing characteristics of both androgenetic alopecia (AGA) and lichen planopilaris. The existing literature on FAPD and current understanding of the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of this disease are reviewed. PubMed searches were performed to identify all articles discussing FAPD. The references of articles were used to identify additional articles. A total of 15 articles were found describing FAPD in a total of 188 patients (164 women and 24 men; average age, 53.8). FAPD affects the androgen-dependent scalp and is typically associated with hair follicle miniaturization. The scalp affected by FAPD shows features of both lichen planopilaris and AGA, and FAPD may possibly represent an exaggerated inflammatory response to damaged hair follicles, triggered by AGA. Physical examination and trichoscopic evidence of follicular inflammation and, occasionally, fibrosis are important to identify the condition, and a dermoscopy-guided biopsy can confirm the diagnosis. Unless recognized, clinicians may misdiagnose FAPD as AGA associated with seborrheic dermatitis. Data on treatment modalities are limited; however, based on pathogenesis, combined therapy with anti-inflammatory and hair growth-promoting agents is warranted.

Sections du résumé

BACKGROUND/OBJECTIVES
Fibrosing alopecia in a pattern distribution (FAPD) is a newly recognized form of scarring alopecia sharing characteristics of both androgenetic alopecia (AGA) and lichen planopilaris. The existing literature on FAPD and current understanding of the epidemiology, pathogenesis, clinical features, diagnosis, and treatment of this disease are reviewed.
METHODS
PubMed searches were performed to identify all articles discussing FAPD. The references of articles were used to identify additional articles.
RESULTS
A total of 15 articles were found describing FAPD in a total of 188 patients (164 women and 24 men; average age, 53.8).
CONCLUSIONS
FAPD affects the androgen-dependent scalp and is typically associated with hair follicle miniaturization. The scalp affected by FAPD shows features of both lichen planopilaris and AGA, and FAPD may possibly represent an exaggerated inflammatory response to damaged hair follicles, triggered by AGA. Physical examination and trichoscopic evidence of follicular inflammation and, occasionally, fibrosis are important to identify the condition, and a dermoscopy-guided biopsy can confirm the diagnosis. Unless recognized, clinicians may misdiagnose FAPD as AGA associated with seborrheic dermatitis. Data on treatment modalities are limited; however, based on pathogenesis, combined therapy with anti-inflammatory and hair growth-promoting agents is warranted.

Identifiants

pubmed: 31926219
pii: S0190-9622(20)30030-X
doi: 10.1016/j.jaad.2019.12.056
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1557-1564

Informations de copyright

Copyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Jacob Griggs (J)

Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: jwg63@med.miami.edu.

Ralph M Trüeb (RM)

Center for Dermatology and Hair Diseases, Zurich-Wallisellen, Switzerland.

Maria Fernanda Reis Gavazzoni Dias (MFR)

Department of Dermatology of the Fluminense Federal University, Antonio Pedro University Hospital, Niteroi, Brazil.

Maria Hordinsky (M)

Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota.

Antonella Tosti (A)

Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida.

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Classifications MeSH