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.

中文翻译：

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呈模式分布的纤维性脱发

背景/目标

模式分布中的纤维化脱发 (FAPD) 是一种新发现的瘢痕性脱发形式，具有雄激素性脱发 (AGA) 和扁平苔藓的共同特征。回顾了有关 FAPD 的现有文献以及目前对该病的流行病学、发病机制、临床特征、诊断和治疗的认识。

方法

执行 PubMed 搜索以识别所有讨论 FAPD 的文章。文章的参考文献用于识别其他文章。

结果

在总共 188 名患者（164 名女性和 24 名男性；平均年龄 53.8 岁）中发现了 15 篇描述 FAPD 的文章。

结论

FAPD 影响依赖雄激素的头皮，通常与毛囊小型化有关。受 FAPD 影响的头皮显示出扁平苔藓和 AGA 的特征，FAPD 可能代表了由 AGA 引发的对受损毛囊的过度炎症反应。体格检查和毛囊炎症和纤维化的毛细镜证据对于识别病情很重要，皮肤镜引导下的活检可以确认诊断。除非得到认可，否则临床医生可能会将 FAPD 误诊为与脂溢性皮炎相关的 AGA。治疗方式的数据有限；然而，根据发病机制，需要抗炎和促进毛发生长的药物联合治疗。