雄秃样纤维性秃发一例  

Fibrosing alopecia in a pattern distribution:a case report

作　　者：李中明[1] 许文嵘[1] 朱麒麟 朱晶 孙杰[1] 尹莉 李煜乾 彭安易 杜旭峰[1] Dirk M.Elston Li Zhongming;Xu Wenrong;Zhu Qilin;Zhu Jing;Sun Jie;Yin Li;Li Yuqian;Peng Anyi;Du Xufeng;Dirk MElston(Department of Dermatology,The Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi 214023,Jiangsu,China;Department of Dermatology and Dermatological Surgery,Medical University of South Carolina,Charleston,SC 29425,USA)

机构地区：[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SC29425

出　　处：《中华皮肤科杂志》2020年第5期356-359,共4页Chinese Journal of Dermatology

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。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.

关 键 词：秃发 雄秃样纤维性秃发 雄激素性秃发 瘢痕性秃发 

分 类 号：R75[医药卫生—皮肤病学与性病学]