Differential Diagnosis of Female-Pattern Hair Loss

A 45-year-old healthy female presented to the dermatologic clinic with a 6-month history of diffuse hair loss and thinning but no relevant medical or pharmacological history. Scalp examination showed low-density hair in a diffuse pattern, which was more pronounced in the parietal and frontal areas ( fig. 1 a). The pull test was positive. Scalp dermoscopy revealed hair-shaft thinning and a lot of yellow dots ( fig. 1 b). Two 4-mm skin punch biopsies were performed in the parietal scalp and showed a nonscarring alopecia with an increased number of catagen/ telogen miniaturized follicles ( fig. 2 a) and some follicular bulbs with melanin pigment casts and mild peribulbar lymphocytic inflammatory infiltrate ( fig. 2 b). Received: February 22, 2016 Accepted: March 24, 2016 Published online: May 5, 2016