Clinicopathological features and treatment outcomes of fibrosing alopecia in a pattern distribution: a multicentre cohort study
Issued Date
2026-02-24
Resource Type
eISSN
13652230
Scopus ID
2-s2.0-105030948940
Pubmed ID
41066610
Journal Title
Clinical and Experimental Dermatology
Volume
51
Issue
3
Start Page
411
End Page
417
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical and Experimental Dermatology Vol.51 No.3 (2026) , 411-417
Suggested Citation
Tang G.T., Triwongwaranat D., De Souza Teixeira M., Gavazzoni Dias M.F.R., Harries M., Holmes S., Suchonwanit P., Saceda-Corralo D., Boyle A., Wall D., Sinclair R., Gil-Redondo R., Vañó-Galván S., Asfour L., Khobzei K., Muttoni E., Nirenberg A., Bhoyrul B. Clinicopathological features and treatment outcomes of fibrosing alopecia in a pattern distribution: a multicentre cohort study. Clinical and Experimental Dermatology Vol.51 No.3 (2026) , 411-417. 417. doi:10.1093/ced/llaf444 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/115491
Title
Clinicopathological features and treatment outcomes of fibrosing alopecia in a pattern distribution: a multicentre cohort study
Author's Affiliation
University of Melbourne
University of Glasgow
Universidade Federal Fluminense
Faculty of Biology, Medicine and Health
Hospital Universitario Ramón y Cajal
V. N. Karazin Kharkiv National University
Siriraj Hospital
Salford Royal Hospital
Ramathibodi Hospital
Mater Misericordiae University Hospital
UCD School of Medicine
Chelsea and Westminster Hospital NHS Foundation Trust
Royal Hospital for Children, Glasgow
BlackRock, Inc.
Grupo de Dermatología Pedro Jaén
Sinclair Dermatology
Dorevitch Pathology
Antonio Pedo University Hospital
University of Glasgow
Universidade Federal Fluminense
Faculty of Biology, Medicine and Health
Hospital Universitario Ramón y Cajal
V. N. Karazin Kharkiv National University
Siriraj Hospital
Salford Royal Hospital
Ramathibodi Hospital
Mater Misericordiae University Hospital
UCD School of Medicine
Chelsea and Westminster Hospital NHS Foundation Trust
Royal Hospital for Children, Glasgow
BlackRock, Inc.
Grupo de Dermatología Pedro Jaén
Sinclair Dermatology
Dorevitch Pathology
Antonio Pedo University Hospital
Corresponding Author(s)
Other Contributor(s)
Abstract
BACKGROUND: Fibrosing alopecia in a pattern distribution (FAPD) is a lymphocytic primary cicatricial alopecia first described in 2000. However, to date, the FAPD literature remains sparse. OBJECTIVES: To identify clinicopathological features and treatment outcomes of FAPD in a large multicentre cohort. METHODS: Patients who had biopsy-proven FAPD were selected from nine specialist hair clinics and were reviewed retrospectively to evaluate the clinical pattern of hair loss, trichoscopic and histopathological features, and response to treatment. RESULTS: Of 110 patients, with a mean age of onset of 52.5 (SD 14.8) years, 94 (85.5%) were women. The most common trichoscopic findings were loss of follicular ostia (97.2%, 103/106) and anisotrichia (97%, 84/87). Histopathological examination revealed perifollicular lymphocytic infiltration in 96.1% (99/103) and concentric lamellar fibrosis in 97% (92/95). After a median duration of treatment of 24 [interquartile range (IQR) 13-50] months, there was stabilization in hair density [median Sinclair grade 3.0 (IQR 3.0-4.0) pretreatment vs. 3.0 (IQR 2.0-4.0) post-treatment, P = 0.62]. Out of the 42 patients who received treatment for ≥ 12 months, 23 achieved stabilization and 16 demonstrated improvement in hair density. CONCLUSIONS: Limitations of the study include its retrospective design and disparate treatments. FAPD may be prone to misdiagnosis because of overlapping clinicopathological features with androgenetic alopecia. A combination of anti-inflammatory (for example, topical corticosteroids) and hair growth-promoting agents (for example, topical or low-dose oral minoxidil) can stabilize the condition or even promote hair regrowth.