瘢痕性女性型脱发1例  

A case of cicatricial female pattern hair loss

作　　者：李中明 许文嵘 朱麒麟 朱晶 李煜乾 孙杰 尹莉 杜旭峰 Li Zhongming;Xu Wenrong;Zhu Qilin;Zhu Jing;Li Yuqian;Sun Jie;Yin Li;Du Xufeng(Department of Dermatology,The Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi 214023,Jiangsu,China)

机构地区：[1]南京医科大学附属无锡人民医院皮肤科,无锡214023

出　　处：《中华皮肤科杂志》2022年第2期142-145,共4页Chinese Journal of Dermatology

摘　　要：报道1例瘢痕性女性型脱发。患者女,36岁,因脱发加重十余年就诊。皮肤科检查:弥漫性头发稀疏,发质细软,可见多数铅笔橡皮擦样大小的灶性秃发区。TrichoScan检查提示额部毛发密度明显降低,毛发直径变异度大于20%,毳毛比例明显增加。毛发镜检查:毳毛增加,可见大量直径3~5mm的灶性秃发区域,部分毛囊开口消失,可见融合性白点征。头皮纵-横组合切片组织病理检查显示,微小化毛囊为著的漏斗、峡部苔藓样毛囊炎改变,毛囊周围同心层状纤维化,毛囊数量较正常同龄人明显减少,毳毛比例增多,大量微型化毛囊及毛囊索,毛囊性微瘢痕形成。诊断:瘢痕性女性型脱发。治疗:外用5%米诺地尔搽剂每日1次,交替外用他克莫司软膏、丙酸氯倍他索软膏;口服螺内酯20mg每日2次,复方甘草酸苷胶囊50mg每日3次。治疗半年后随访,脱发无明显加重,继续随访中。A case of cicatricial female pattern hair loss was reported.A 36-year-old female patient presented with gradually aggravated hair loss for more than 10 years.Skin examination showed diffuse hair thinning on the scalp,thin and soft hairs,and some pencil eraser-sized areas of focal atrichia.TrichoScan examination revealed markedly decreased hair density on the forehead,variability in hair diameter greater than 20%,and increased proportions of vellus hairs.Dermoscopic examination showed increased numbers of vellus hairs,plenty of focal atrichia areas measuring 3-5 mm in diameter,loss of some follicular ostia,and confluent white dots.Histopathological examination of vertical and transverse scalp sections showed predominantly distributed miniaturized hair follicles with lichenoid folliculitis around the infundibulum and isthmus,concentrically layered perifollicular fibrosis,a marked decrease in the number of hair follicles compared with healthy people of the same age,increased proportions of vellus hairs,a large number of miniaturized hair follicles and follicular streamers,and formation of follicular micro-scars.The patient was diagnosed with cicatricial female pattern hair loss.She received topical treatment with 5%minoxidil liniment once a day,and alternate treatment with-topical tacrolimus ointment and clobetasol propionate ointment,as well as oral spironolactone at a dose of 20 mg twice a day and compound glycyrrhizin capsules at a dose of 50 mg thrice a day.After half a year of treatment,there was no marked aggravation of hair loss,and the follow-up continued.

关 键 词：秃发 瘢痕性秃发 雄激素性秃发 瘢痕性女性型脱发 

分 类 号：R758.71[医药卫生—皮肤病学与性病学]