Dermatology Practical & Conceptual
Retrograde involvement in androgenetic alopecia: a narrative review and clinical case series
By Nicolò Rivetti and Piero Tesauro.
Abstract
Introduction
Retrograde androgenetic alopecia (RA) describes a pattern of follicular miniaturization predominantly involving the lower and lateral occipital scalp. Although clinically relevant, RA is not included in classical androgenetic alopecia classifications and remains inconsistently defined in the literature.
Objectives
To review current dermatologic and surgical perspectives on RA and related unpatterned alopecia variants, and to describe a monocentric clinical–trichoscopic case series highlighting the limitations of existing classification systems.
Methods
A narrative review was conducted using PubMed/MEDLINE and Google Scholar, focusing on retrograde androgenetic alopecia, donor area involvement, and unpatterned alopecia. In addition, ten male patients with retrograde involvement were retrospectively analyzed using clinical examination and trichoscopy. Cases were evaluated according to anatomical distribution, global pattern phenotype, and donor area stability.