Frontal Fibrosing Alopecia Presenting as Androgenetic Alopecia in an African American Woman

This case report described a 53-year-old African American woman with frontal fibrosing alopecia (FFA) that clinically resembled androgenetic alopecia, highlighting the need for physicians to consider FFA in black patients presenting with frontotemporal alopecia. The patient exhibited hair loss along the frontal hairline, which did not improve with minoxidil treatment. A biopsy confirmed FFA through findings of dense perifollicular inflammation and loss of sebaceous glands, without miniaturization or dermal mucin. Despite treatment with intralesional triamcinolone, clobetasol, hydroxychloroquine, and minoxidil, her alopecia did not stabilize. The report emphasized that FFA, typically associated with post-menopausal Caucasian women, might be underdiagnosed in black women due to assumptions about more common types of alopecia in this demographic.