{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:32:02Z","timestamp":1787841122982,"version":"build-2784847793"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Fibrosing alopecia in a pattern distribution (FAPD) is a cicatricial alopecia characterized by an androgenetic alopecia (AGA)-like pattern hair loss (PHL) associated with a lichen planopilaris (LPP)-like infiltrate on histopathology. Prepubertal PHL is the term proposed for AGA in children. The pattern is exclusively that of female PHL. We report the first case of FAPD in a child with prepubertal PHL. A 9-year-old girl initially presented with chronic itching, redness, and scaling of the central scalp area, which eventually developed to a cicatricial PHL with histopathological evidence of LPP. The implication of a follicular microinflammation and fibrosis associated with AGA has emerged from several studies. Ultimately, Zinkernagel and Tr\u00fceb reported a peculiar cicatricial PHL with histopathological features of LPP and named it FAPD. So far, FAPD has only been observed in adults. The observation of FAPD in a child with prepubertal PHL suggests that the condition is not androgen dependent and may explain the limited efficacy of 5-alpha reductase inhibitors for treatment of FAPD. The primary aims for treatment are anti-inflammatory in combination with a hair growth-promoting agent such as minoxidil.<\/jats:p>","DOI":"10.4103\/ijt.ijt_60_24","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T10:02:00Z","timestamp":1762250520000},"page":"137-139","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Prepubertal Fibrosing Alopecia in a Pattern Distribution"],"prefix":"10.4103","volume":"17","author":[{"given":"Nikollas","family":"Munhoz","sequence":"first","affiliation":[{"name":"Center for Dermatology and Hair Diseases Professor Tr\u00fceb, University Hospital of Zurich, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jivko","family":"Kamarachev","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospital of Zurich, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph Michel","family":"Tr\u00fceb","sequence":"additional","affiliation":[{"name":"Center for Dermatology and Hair Diseases Professor Tr\u00fceb, University Hospital of Zurich, Z\u00fcrich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"R1-20251105","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1111\/j.1749-6632.1951.tb31971.x","article-title":"Patterned loss of hair in man;types and incidence","volume":"53","author":"Hamilton","year":"1951","journal-title":"Ann N Y Acad Sci"},{"key":"R2-20251105","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1097\/00007611-197511000-00009","article-title":"Male pattern baldness: Classification and incidence","volume":"68","author":"Norwood","year":"1975","journal-title":"South Med 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planopilaris or androgenetic alopecia with a lichenoid tissue reaction pattern?","volume":"136","author":"Zinkernagel","year":"2000","journal-title":"Arch Dermatol"},{"key":"R7-20251105","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/j.jaad.2019.12.056","article-title":"Fibrosing alopecia in a pattern distribution","volume":"85","author":"Griggs","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"R8-20251105","doi-asserted-by":"crossref","first-page":"108","DOI":"10.4103\/ijt.ijt_55_22","article-title":"Efficacy, tolerability, and superiority of propylene glycol-free, North American witch-hazel (Hamamelis virginiana)-based solution of 5% minoxidil sulfate for the treatment of female androgenetic alopecia","volume":"15","author":"Tr\u00fceb","year":"2023","journal-title":"Int J Trichology"},{"key":"R9-20251105","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1177\/002215549804600310","article-title":"Clusters of perifollicular macrophages in normal murine skin: Physiological degeneration of selected hair follicles by programmed organ deletion","volume":"46","author":"Eichm\u00fcller","year":"1998","journal-title":"J Histochem Cytochem"},{"key":"R10-20251105","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1002\/path.4233","article-title":"Lichen planopilaris is characterized by immune privilege collapse of the hair follicle's epithelial stem cell niche","volume":"231","author":"Harries","year":"2013","journal-title":"J Pathol"},{"key":"R11-20251105","doi-asserted-by":"crossref","first-page":"80","DOI":"10.4103\/ijt.ijt_83_17","article-title":"Graft versus host disease presenting as fibrosing alopecia in a pattern distribution: A model for pathophysiological understanding of cicatricial pattern hair loss","volume":"10","author":"Rezende","year":"2018","journal-title":"Int J Trichology"}],"container-title":["International Journal of 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