Clinical, trichoscopic, and histological characteristics of 46 hispanic men with fibrosing alopecia in a pattern distribution: a retrospective multicenter analysis

Background: Fibrosing alopecia in a pattern distribution (FAPD) is an infrequent presentation of primary cicatricial alopecia with clinical, histopathological and trichoscopic features of Androgenetic Alopecia (AGA), as well as Lichen Planopilaris (LPP). Objectives: The aim of this study is to describe the clinical, trichoscopic and histopathological features of 46 hispanic male patients with FAPD. Methods: This was a retrospective study from 8 dermatological centers across four countries: Argentina, Colombia, Mexico, and Peru. Patients with clinical diagnosis of FAPD performed by 12 dermatologists experienced in trichology from 2015 to 2022 were included. Results: = 39) had a family history of AGA. In terms of clinical characteristics, the Male Pattern of Hair Loss (MPHL) was the most common (65%). All patients showed a symmetrical distribution of the alopecia. Regarding the trichoscopic characteristics, the most frequent finding was perifollicular desquamation (96%), while most common histological finding was concentric perifollicular lamellar fibrosis (100%). FAPD was the initial clinical suspicion in only 6 patients (13%), and androgenetic alopecia was the primary initial suspicion (56.5%). Conclusion: The age of onset of FAPD appears to be earlier in Latin American male patients compared with European and North American male patients. Most male patients with FAPD clinically resemble AGA in their classic pattern of hair loss.