Despite a significant increase in reported cases of frontal fibrosing alopecia (FFA) in literature, discussion about the possible role of environmental factors, instruction for diagnosis and guideline for treatment, are limited. The review aims to provide a detailed synthesis of this condition that could be used by clinicians in their practise. Whether single-centre or multicentre, studies of more than 60 cases less than 5 years old were mainly taken into consideration. Results obtained were that FFA affects mainly postmenopausal Caucasian women; the most common comorbidities are hyperlipidaemia, arterial hypertension, osteoporosis, hypothyroidism, depression, alongside dermatological disorders such as atopic dermatitis, rosacea, seborrheic dermatitis and androgenetic alopecia. Autoimmune, genetic, hormonal (e.g. estrogen deficiency, pregnancy, lactation, HRT and raloxifene) and environmental (e.g. daily use of facial sunscreens and less frequent use of hair dyes and shampoo) hypotheses were proposed for pathogenesis, as well as association with various predisposing factors (patient's health-social profile, disease's history and comorbidities). Clinical presentation of FFA can be divided into 3 specific patterns, each with a different prognosis. Diagnosis is usually made clinically with the use of trichoscopy; however, scalp biopsy remains the gold standard. The condition is regarded as a variant of lichen planopilaris (LPP) due to the similarity of the prominent histopathological findings, but the clinical image is distinct and therapeutic options vary. 5α-reductase inhibitors, intralesional steroids, and hydroxychloroquine provide the highest level of evidence for the treatment of FFA. The conclusion is that a better understanding of the disease is crucial for proper disease management.
Heart failure (HF) has been recognized as a pandemic and is a serious clinical and health problem associated with significant mortality, morbidity and expenditure on healthcare, especially among older people. Progress in medicine has made it possible for an increasing number of people with HF to live longer than ever before. Therefore, a new and serious clinical problem has appeared-advanced heart failure (AHF). A better understanding of this issue is very important, because there are many more patients waiting for transplantations than there are available hearts. The role of the medical team is to keep the patient in the best condition until the heart transplant/implantation of left ventricular assist devices or at least to ensure the best possible quality of life. This article reviews the available data on AHF. The authors have succinctly presented different definitions and methods of the AHF diagnosis established by medical societies, as well as epidemiological data, methods of assessment, and possible treatment strategies.
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