雄秃样纤维性秃发一例

doi:10.35541/cjd.20191142

中华皮肤科杂志 ›› 2020, Vol. 53 ›› Issue (5): 356-359.doi: 10.35541/cjd.20191142

雄秃样纤维性秃发一例

李中明¹ 许文嵘¹ 朱麒麟¹ 朱晶¹ 孙杰¹ 尹莉¹ 李煜乾¹ 彭安易¹ 杜旭峰¹ Dirk M. Elston²

¹南京医科大学附属无锡市人民医院皮肤科，无锡 214023；²美国南卡罗来纳医科大学皮肤及皮肤外科，查尔斯顿 SC 29425

收稿日期:2019-12-09 修回日期:2020-02-19 发布日期:2020-04-30
通讯作者: 杜旭峰 E-mail:xufengdu@njmu.edu.cn

Fibrosing alopecia in a pattern distribution: a case report

Li Zhongming¹, Xu Wenrong¹, Zhu Qilin¹, Zhu Jing¹, Sun Jie¹, Yin Li¹, Li Yuqian¹, Peng Anyi¹, Du Xufeng¹, Dirk M. Elston²

¹Department of Dermatology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, Jiangsu, China; ²Department of Dermatology and Dermatological Surgery, Medical University of South Carolina, Charleston, SC 29425, USA

Received:2019-12-09 Revised:2020-02-19 Published:2020-04-30
Contact: Du Xufeng E-mail:xufengdu@njmu.edu.cn

摘要/Abstract

摘要： 【摘要】报道1例雄秃样纤维性秃发（FAPD）及其临床病理、皮肤镜和TrichoScan特征，以提高对FAPD的认识。患者男，23岁，前额及头顶部进行性脱发10年，伴局部头发变细、软，偶有头皮瘙痒。皮肤科检查：前额至头顶部头发弥漫性稀疏，前额发际线后移，局部发质细软，脱发区可见部分毛囊角化性丘疹、毛囊周围红斑，未见明显鳞屑。TrichoScan检查：毛发密度明显降低，毳毛比例增加。皮肤镜检查：部分毛囊开口消失，融合性白点征。头皮组织病理检查：毛囊漏斗部、峡部淋巴细胞苔藓样浸润，毛囊周围同心层状纤维化，毛囊结构破坏，毛囊性微瘢痕形成，残留毛囊直径变异度明显增加，可见部分毳毛。诊断：FAPD。FAPD临床易误诊为雄激素性秃发，需及早诊断并治疗。

关键词: 秃发, 雄秃样纤维性秃发, 雄激素性秃发, 瘢痕性秃发

Abstract: 【Abstract】 A case of fibrosing alopecia in a pattern distribution （FAPD） and its clinicopathological, dermoscopic and TrichoScan features were reported to improve the understanding of FAPD. A 23-year-old male patient presented with progressive hair loss on the forehead and top of the head for 10 years, local hair thinning and softening, and occasional scalp itching. Skin examination showed diffuse sparseness of hair from the forehead to the top of the head, frontal hairline recession, focal thinning and softening of hair, some follicular keratotic papules and perifollicular erythema on the alopecic area, with no obvious scales. TrichoScan examination revealed markedly decreased hair density and increased proportions of vellus hairs. Dermoscopy showed loss of some follicular ostia and confluent white dots. Histopathological examination of the scalp showed lichenoid lymphocytic infiltration around the infundibulum and isthmus of hair follicles, concentrically layered perifollicular fibrosis, hair follicle destruction, formation of follicular micro-scars, markedly increased variation in the diameter of residual follicles, and some vellus hairs. The patient was diagnosed with FAPD. FAPD is easily misdiagnosed as androgenetic alopecia, and early diagnosis and treatment are needed.

Key words: Alopecia, Fibrosing alopecia in a pattern distribution, Androgenetic alopecia, Scarring alopecia

李中明许文嵘朱麒麟朱晶孙杰尹莉李煜乾彭安易杜旭峰 Dirk M.Elston. 雄秃样纤维性秃发一例[J]. 中华皮肤科杂志, 2020,53(5):356-359. doi:10.35541/cjd.20191142

Li Zhongming, Xu Wenrong, Zhu Qilin, Zhu Jing, Sun Jie, Yin Li, Li Yuqian, Peng Anyi, Du Xufeng, Dirk M. Elston. Fibrosing alopecia in a pattern distribution: a case report[J]. Chinese Journal of Dermatology, 2020, 53(5): 356-359.doi:10.35541/cjd.20191142

参考文献 20

［1］	Zinkernagel MS, Trüeb RM. Fibrosing alopecia in a pattern distribution: patterned lichen planopilaris or androgenetic alopecia with a lichenoid tissue reaction pattern?［J］. Arch Dermatol, 2000,136（2）:205⁃211. doi: 10.1001/archderm.136.2. 205.
［2］	Amato L, Chiarini C, Berti S, et al. Case study: fibrosing alopecia in a pattern distribution localized on alopecia androgenetica areas and unaffected scalp［J］. Skinmed, 2004,3（6）:353⁃355. doi: 10.1111/j.1540⁃9740.2004.03687.x.
［3］	Chiu HY, Lin SJ. Fibrosing alopecia in a pattern distribution［J］. J EurAcad Dermatol Venereol, 2010,24（9）:1113⁃1114. doi: 10. 1111/j.1468⁃3083.2010.03580.x.
［4］	Ramanauskaite A, Trüeb RM. Facial papules in fibrosing alopecia in a pattern distribution （cicatricial pattern hair loss）［J］. Int J Trichology, 2015,7（3）:119⁃122. doi: 10.4103/0974⁃7753.167463.
［5］	Missio DM, Dias M, Trüeb RM. Familial cicatricial alopecia: report of familial frontal fibrosing alopecia and fibrosing alopecia in a pattern distribution［J］. Int J Trichology, 2017,9（3）:130⁃134. doi: 10.4103/ijt.ijt_59_17.
［6］	Mardones F, Hott K, Martinez MC. Clinical study of fibrosing alopecia in a pattern distribution in a Latin American population［J］. Int J Dermatol, 2018,57（2）:e12⁃e14. doi: 10.1111/ijd.13871.
［7］	Rezende HD, Reis Gavazzoni Dias MF, Trüeb RM. Graft versus host disease presenting as fibrosing alopecia in a pattern distribution: amodel for pathophysiological understanding of cicatricial pattern hair loss［J］. Int J Trichology, 2018,10（2）:80⁃83. doi: 10.4103/ijt.ijt_83_17.
［8］	Billero V, Oberlin KE, Miteva M. Red dots in a net⁃like pattern on the upper chest: a novel clinical observation in frontal fibrosing alopecia and fibrosing alopecia in pattern distribution［J］. Skin Appendage Disord, 2018,4（1）:47⁃49. doi: 10.1159/000478947.
［9］	Teixeira MS, Gavazzoni Dias M, Trüeb RM, et al. Fibrosing alopecia in a pattern distribution （FAPD） in 16 African⁃descent and Hispanic female patients: a challenging diagnosis［J］. Skin Appendage Disord, 2019,5（4）:211⁃215. doi: 10.1159/000496837.
［10］	Triyangkulsri K, Srisuwanwattana P, Sriphojanart T, et al. Fibrosing alopecia in a pattern distribution: a case report and literature review［J］. Case Rep Dermatol, 2019,11（3）:297⁃302. doi: 10.1159/000503681.
［11］	李中明, 许文嵘, 李煜乾, 等. 改良的Ho⁃Vert法切片对21例经典型毛发扁平苔藓临床病理诊断价值的观察［J］. 中华皮肤科杂志, 2020,53（1）:17⁃22. doi: 10.35541/cjd.20190755.
［12］	Sperling LC, Solomon AR, Whiting DA. A new look at scarring alopecia［J］. Arch Dermatol, 2000,136（2）:235⁃242. doi: 10.1001/ archderm.136.2.235.
［13］	汤顺利, 方红. 雄激素性秃发的发病机制［J］. 中华皮肤科杂志, 2019,52（3）:208⁃210. doi: 10.3760/cma.j.issn.0412⁃4030. 2019.03.014.
［14］	胡瑞铭, 徐峰, 盛友渔, 等. 雄激素性秃发的皮肤镜特点及其与临床的关系［J］. 中华皮肤科杂志, 2014,47（9）:642⁃645. doi: 10.3760/cma.j.issn.0412⁃4030.2014.09.009.
［15］	Kossard S. Postmenopausal frontal fibrosing alopecia. Scarring alopeciain a pattern distribution［J］. Arch Dermatol, 1994,130（6）: 770⁃774.doi:10.1001/archderm.1994.01690060100013.
［16］	Dlova NC, Salkey KS, Callender VD, et al. Central centrifugal cicatricial alopecia: new insights and a call for action［J］. J Investig Dermatol Symp Proc, 2017,18（2）:S54⁃S56. doi:10.1016/ j.jisp.2017.01.004.
［17］	Olsen EA, Bergfeld WF, Cotsarelis G, et al. Summary of North American Hair Research Society （NAHRS）⁃sponsored workshop on cicatricial alopecia, Duke University Medical Center, February 10 and 11, 2001［J］. J Am Acad Dermatol, 2003,48（1）:103⁃110. doi: 10.1067/mjd.2003.68.
［18］	Ogunleye TA, McMichael A, Olsen EA. Central centrifugal cicatricial alopecia: what has been achieved, current clues for future research［J］. Dermatol Clin, 2014,32（2）:173⁃181. doi: 10.1016/j.det.2013.12.005.
［19］	Herskovitz I, Miteva M. Central centrifugal cicatricial alopecia: challenges and solutions［J］. Clin Cosmet Investig Dermatol, 2016,9:175⁃181. doi: 10.2147/CCID.S100816.
［20］	Fung MA, Sharon VR, Ratnarathorn M, et al. Elastin staining patterns in primary cicatricial alopecia［J］. J Am Acad Dermatol, 2013,69（5）:776⁃782. doi: 10.1016/j.jaad.2013.07.018.

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雄秃样纤维性秃发一例

Fibrosing alopecia in a pattern distribution: a case report

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