Focal Atrichia: A Diagnostic Clue in Female Pattern Hair Loss

Publication date: Available online 7 October 2017
Source:Journal of the American Academy of Dermatology
Author(s): Elise A. Olsen, David A. Whiting
BackgroundFocal atrichia is a common clinical finding in female pattern hair loss whose specificity and histologic findings need further clarification.ObjectiveTo determine the frequency of focal atrichia in various types of hair loss and its histologic characteristics in female pattern hair loss.MethodsPart 1: Review of 250 consecutive female patients seen with hair loss for the presence of focal atrichia and Part 2: paired biopsies of haired areas vs focal atrichia in 18 subjects with female pattern hair lossResultsFocal atrichia was seen in 46/104 (44%) of women with female pattern hair loss, including 67% of late onset vs 15% of early onset, compared to 3/146 (2%) of those with other hair disorders Biopsy findings of focal atrichia in female pattern hair loss showed primarily a more progressive miniaturization process than that of haired areas of the scalp.LimitationsSome women with female pattern hair loss may have had concomitant chronic telogen effluviumConclusionsWhen present, focal atrichia is a clinical clue to the diagnosis of female pattern hair loss, particularly late onset subtype.