{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T20:49:56Z","timestamp":1762807796514},"reference-count":59,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2006,8,30]],"date-time":"2006-08-30T00:00:00Z","timestamp":1156896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2006,11]]},"abstract":"<jats:p><jats:bold>Background:\u2002<\/jats:bold> Patterned hair loss, follicular miniaturization, and increased telogen hair counts characterize androgenic alopecia (AGA). Follicular inflammation in AGA has been associated with treatment resistance and progressive hair loss.<\/jats:p><jats:p><jats:bold>Case report:\u2002<\/jats:bold> Brothers, 15 and 18\u2003years old, presented with frontal and mid\u2010scalp hair loss with an intact frontal hairline noted over a 1\u2010year period. The elder reported past use of androgenic steroids. Laboratory assessment for metabolic and hormonal abnormalities was unrevealing, and hair pull test was negative. Scalp biopsies revealed decreased terminal hairs, marked diameter variation of anagen hairs, decreased terminal to vellus hair ratios (3.7:1\/3.4:1, older\/younger), and increased telogen counts (23%\/21%). Infrabulbar and peri\u2010isthmic (follicular bulge region) lymphocytic infiltrates were present. Hair loss has progressed, unabated by daily topical 0.5% clobetasol (for 6 months), daily 5% minoxidil (1 year), and latter, daily oral finasteride (2 years \u2013 older brother only).<\/jats:p><jats:p><jats:bold>Discussion:\u2002<\/jats:bold> Based on patterned hair loss and miniaturized hairs, these brothers have AGA. The female pattern of hair loss (diffuse hair loss affecting the central scalp with preservation of frontal hair line) coupled with follicular isthmic lymphocytic inflammation represents an unusual presentation, possibly a treatment resistant, inflammatory variant of AGA. The differential diagnosis includes exogenous androgen\u2010mediated hair loss, cicatricial pattern hair loss, or the superimposition of alopecia areata.<\/jats:p>","DOI":"10.1111\/j.1600-0560.2006.00543.x","type":"journal-article","created":{"date-parts":[[2006,8,30]],"date-time":"2006-08-30T19:43:32Z","timestamp":1156967012000},"page":"741-748","source":"Crossref","is-referenced-by-count":6,"title":["Female\u2010patterned alopecia in teenage brothers with unusual histologic features"],"prefix":"10.1111","volume":"33","author":[{"given":"J. Andrew","family":"Carlson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jozef","family":"Malysz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,11,3]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-0960.1998.tb01476.x"},{"key":"e_1_2_5_3_2","article-title":"Diseases on hair follicles leading to hair loss part I: nonscarring alopecias","volume":"3","author":"Wiedemeyeer K","year":"2004","journal-title":"Skinmed"},{"key":"e_1_2_5_4_2","article-title":"The diagnosis of androgenetic alopecia","volume":"8","author":"Olsen E","year":"1998","journal-title":"Dermatol Ther"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1085-5629(99)80013-3"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2002.124068"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06442.x"},{"issue":"5","key":"e_1_2_5_8_2","doi-asserted-by":"crossref","DOI":"10.1016\/S0190-9622(08)81702-1","article-title":"Female pattern baldness in men","volume":"29","author":"Trueb RM","year":"1993","journal-title":"J Am Acad Dermatol"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.04.008"},{"key":"e_1_2_5_10_2","volume-title":"4th Inter Continental Meeting of Hair Research Societies; 2004","author":"Olsen E","year":"2004"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1087-0024.2005.10109.x"},{"issue":"3","key":"e_1_2_5_12_2","article-title":"Dermatopathology of common hair problems","volume":"3","author":"Whiting D","year":"1999","journal-title":"J Cutan Med Surg"},{"key":"e_1_2_5_13_2","article-title":"Scalp biopsy as a diagnostic and prognostic tool in androgenetic alopecia","volume":"8","author":"Whiting DA","year":"1998","journal-title":"Dermatol Ther"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.139.12.1555"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000372-199902000-00011"},{"key":"e_1_2_5_16_2","article-title":"Dermatologists and anabolic\u2010androgenic drug abuse","volume":"44","author":"Scott MJ","year":"1989","journal-title":"Cutis"},{"key":"e_1_2_5_17_2","article-title":"Drug\u2010induced hair loss and hair growth. 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