Abstract
A 47-year-old man complained of symmetrical hair loss associated with itching. Trichoscopy revealed hair shaft variability, perifollicular erythema, loss of follicular ostia and casts suggesting features of both androgenetic alopecia and lichen planopilaris. A trichoscopy guided biopsy specimen revealed a lymphohistiocytic infiltrate around the isthmus and infundibular region of the hair follicle with interface dermatitis. Hence the diagnosis of fibrosing alopecia in a pattern distribution (FAPD) was made. He was counselled to undergo medical management with clobetasol propionate solution and oral minoxidil and avoid hair transplantation due to the risk of koebnerization.