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Journal of the American Academy of Dermatology
Volume 80, n° 6
page 1538 (juin 2019)
Doi : 10.1016/j.jaad.2017.09.064
accepted : 29 September 2017
Original Articles

Focal atrichia: A diagnostic clue in female pattern hair loss

Elise A. Olsen, MD a, , David A. Whiting, MD b
a Duke University Medical Center, Durham, North Carolina 
b Hair and Skin Research and Treatment Center, Dallas, Texas 

Correspondence to: Elise A. Olsen, MD, Box 3294, Duke University Medical Center, Durham, NC 27710.Box 3294Duke University Medical CenterDurhamNC27710

Focal atrichia is a common clinical finding in female pattern hair loss, the specificity and histologic findings of which need further clarification.


To determine the frequency of focal atrichia in various types of hair loss and its histologic characteristics in female pattern hair loss.


Part 1 of the study was a review of 250 consecutive female patients seen with hair loss for the presence of focal atrichia, and part 2 examined paired biopsy specimens from haired areas versus those from areas with focal atrichia in 18 subjects with female pattern hair loss.


Focal atrichia was seen in 46 of 104 of women with female pattern hair loss (44%), including 67% of those with the late-onset subtype versus 15% of those with the early-onset subtype, compared with in 3 of 146 of those with other hair disorders (2%). 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.


Some women with female pattern hair loss may have had concomitant chronic telogen effluvium.


When present, focal atrichia is a clinical clue to the diagnosis of female pattern hair loss, particularly the late-onset subtype.

The full text of this article is available in PDF format.

Key words : anagen, biopsy, female pattern hair loss, focal atrichia, telogen, terminal, vellus

Abbreviations used : ATE, CTE, EFPHL, FA, FFA, FPHL, LFPHL, MPHL, TE

 Supported by an unrestricted educational grant from Pharmacia and Co.
 Conflicts of interest: None declared.
 Previously presented in part at the World Congress of Hair Disorders, Tokyo, Japan, 2001, and at the World Congress of Hair Disorders, Vancouver, Canada, 2007.
 Reprints not available from the authors.

© 2017  American Academy of Dermatology, Inc.@@#104156@@
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