Lonely Hair Sign: Not Specific for Frontal Fibrosing Alopecia

While lonely hairs growing anterior to the frontoparietal hairline and in the preauricular region are markers of frontal fibrosing alopecia,¹ they also are present with any type of scarring alopecia. Isolated hairs are present at the edges of disease progression and in the center of the patches of scarring alopecia with lymphocytic infiltrate as in lupus, follicular keratosis spinulosa decalvans, central centrifugal alopecia and alopecia mucinous, and lichen planus pilaris (Figure 1).