Jerjen R, Pinczewski J, Sinclair R, et al. - Initiation of treatment in early stages of FAPD (fibrosing alopecia in a pattern distribution) was suggested to be associated with a more favourable outcome. In addition, clinicopathological features helpful in the diagnosis of this insidious scarring alopecia were identified.

• This is a study of 24 female patients (mean age 60.7 years) with FAPD.

• The mean Lichen Planopilaris Activity Index score was 1.50, and the median Sinclair grade was 3.

• Hair shaft diameter variability (100%), perifollicular erythema and/or scaling (95%) and loss of follicular ostia (95%) were the main trichoscopic features.

• On histopathological evaluation, there were features of scarring alopecia with interface alterations in follicular epithelia primarily targeting terminal and intermediate hairs, and less commonly, vellus hairs.

• Hair growth-promoting, anti-inflammatory and anti-androgen agents prevented disease progression in 14 patients and led to hair regrowth in two patients.

• Despite treatment, progression of hair loss occurred in six patients.