Mast Cell Infiltration Helps Distinguish Fibrosing Alopecia in a Pattern Distribution From Androgenetic Alopecia in Scalp Biopsy.

Authors

Azadeh Rakhshan, Fateme Ashjaazade, Sahar Dadkhahfar, Farnaz Araghi

Published in

Journal of cutaneous pathology. Oct 20, 2026. Epub Oct 20, 2026.

Abstract

Mast cells are key regulators of cutaneous inflammation and are known to accumulate in response to various immunological stimuli. Although their role in several dermatological conditions has been established, their specific contribution to different forms of alopecia-particularly scarring versus nonscarring types-remains incompletely understood. This study aimed to compare the degree of mast cell infiltration across three distinct types of alopecia: androgenetic alopecia (AGA), fibrosing alopecia in a pattern distribution (FAPD), and lichen planopilaris (LPP).
A total of 56 patients diagnosed with AGA, FAPD, or LPP were enrolled. Scalp biopsies were obtained from all participants, and diagnoses were confirmed through histopathological examination. Mast cell distribution and infiltration density were quantified and analyzed using SPSS and Stata software. The study was conducted with full ethical approval.
The majority of participants (91%) were female, with a mean age of 44.3 years. FAPD was the most prevalent diagnosis (42.9%). LPP demonstrated the highest degree of mast cell infiltration, while AGA exhibited the lowest (ANOVA, p < 0.001). Post hoc analysis revealed significant differences between AGA and FAPD (-17.7%, p = 0.001) and between AGA and LPP (-20.1%, p = 0.001). Although mast cell infiltration was higher in patients over 40 years of age, this difference did not reach statistical significance. No significant association was identified between mast cell infiltration and patient sex.
Mast cell infiltration is significantly more pronounced in scarring alopecias (LPP and FAPD) compared to non-scarring AGA, suggesting a shared immunopathological mechanism underlying follicular destruction in scarring subtypes. These findings also raise important questions regarding the potential inflammatory contribution of mast cells to AGA pathogenesis.

PMID:
42902517
Bibliographic data and abstract were imported from PubMed on 21 Oct 2026.

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