title: Diffuse scarring alopecia in a female pattern hair loss distribution.
abstract: We describe three cases of hair loss in a female pattern hair loss (FPHL) distribution with histologic features of lichen planopilaris (LPP). All patients had a history of diffuse, gradual hair loss in a Christmas tree pattern that clinically presented as FPHL on gross and dermoscopic examination. Notably, there were no characteristic clinical signs of LPP and no histologic features of FPHL. These cases are most consistent with cicatricial pattern hair loss (CPHL). This relatively new entity is similar to fibrosing alopecia in a pattern distribution (FAPD) in that they are both scarring alopecias confined to a FPHL distribution, but CPHL lacks the clinical signs of perifollicular erythema and perifollicular keratosis seen in FAPD. These three cases may present an early, subtle form of CPHL and will be of interest to clinicians and histopathologists alike.
authors.affiliation: Dermatology Department, Royal Newcastle Centre, Sydney, Newcastle, New South Wales, Australia.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Fergie
authors.affiliation: Hunter Histo, Sydney, Newcastle, New South Wales, Australia.
authors.forename: Gurpreet
authors.initials: G
authors.lastname: Khaira
authors.affiliation: Douglass Hanly Moir Pathology, Sydney, Newcastle, New South Wales, Australia.
authors.forename: Vicki
authors.initials: V
authors.lastname: Howard
authors.affiliation: Dermatology Department, Royal Newcastle Centre, Sydney, Newcastle, New South Wales, Australia.
authors.forename: Sally
authors.initials: S
authors.lastname: de Zwaan
mesh_terms: D000328:Adult; D000368:Aged; D000505:Alopecia / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D002921:Cicatrix / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D046169:Dermoscopy; D005260:Female; D006801:Humans; D008010:Lichen Planus / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: cicatricial pattern hair loss; female pattern hair loss; fibrosing alopecia in a pattern distribution; lichen planopilaris