such as DI, may even extend on to the facial skin (Fig. 2). An oral healthcare provider (OHCP) may be the first medical professional to provide patient support and refer the individual for initial and/or further psychiatric care if a condition such as DI is suspected and/or known. Topical medications, such as anesthetics, corticosteroids, and antibiotics, may be used for local management. 2 Occlusive splints may be fabricated by OHCPs to minimize trauma to the affected area(s). 2 The authors provided clinicians with a detailed review of an uncommon yet often debilitating condition. Comprehensive management of patients with DI may require a multidisciplinary healthcare team, including psychiatry, primary care medicine, and dermatology. Owing to unique expertise, OHCPs may prove to be an essential member of the team in order to achieve optimal clinical outcomes for patients with DI and other psychodermatologic disorders.
<b><i>Introduction:</i></b> Frontal fibrosing alopecia (FFA) is a scarring alopecia affecting mainly postmenopausal females. Associated clinical signs include facial papules, glabellar red dots, depression of frontal veins, and lichen planus pigmentosus. Our objective was to establish the validity of increased preauricular lines as another clinical marker of FFA. <b><i>Materials and Methods:</i></b> Thirty-two females with FFA were compared to 32 age-matched females with either androgenetic alopecia or chronic telogen effluvium. Bilateral images of the preauricular area were taken, and disease severity was calculated in all FFA patients using the FFA severity scale (FFASS). The average number of preauricular lines were determined and compared based on group, age, and severity. <b><i>Results:</i></b> Patients with FFA had a significantly higher mean number of preauricular lines than controls (<i>p</i> = 0.002). Intergroup analysis among the FFA patients revealed no significant difference between FFASS and the number of wrinkles or the number of wrinkles in patients ≥60 years old. <b><i>Discussion and Conclusion:</i></b> Females with FFA have increased preauricular lines compared to age-matched controls regardless of age, and disease severity was not correlated to increased lines. Although the cause is unknown, atrophy and loss of elastic fibers in biopsies of the preauricular area in diseased patients may contribute. These findings reveal another potential clinical marker of FFA.
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