Clinical features and sex hormone profile in male patients with frontal fibrosing alopecia: A multicenter retrospective study with 33 patients

Doche, Isabella; Nico, Marcello M. S.; Gerlero, Paula; Rebeis, Marina Mattos; Melo, Daniel Fernandes; Tortelly, Violeta Duarte; Ramos, Paulo Müller; Larrondo, Jorge; Mardones, Francisco; González, Martha Lucía; Tosti, Antonella; Machado, Maria Cecília Rivitti

doi:10.1016/j.jaad.2021.04.076

Cited by 4 publications

(9 citation statements)

References 5 publications

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“…While many clinical features of male FFA were similar to those reported in our female cohort, 2 the median age of onset was younger and features such as facial hair loss and facial papules were prominent. Our male FFA cohort was also comparable to several other case series of male FFA, although our participants had a younger median age of onset and less frequent comorbidity with androgenetic alopecia 3–6 . Interestingly, an excess of autoimmune comorbidity compared with general population estimates was noted, as were signs of male hormone imbalance 7,8 .…”

Section: Features Male Ffa Data (N = 17) Female Ffa Data (N = 711)asupporting

confidence: 80%

“…Mycoplasma-induced SJS/TEN is increasingly reported as having unique clinical features, including sparse cutaneous involvement, prominent mucositis or possibly a milder phenotype. [4][5][6] However, this is inconsistent with our series where proven Mycoplasma infection was associated with widespread cutaneous disease (TEN) and recurrent episodes. Not all the milder cases were tested for Mycoplasma and we cannot exclude undiagnosed Mycoplasma infection.…”

contrasting

confidence: 74%

“…As FFA disproportionately affects postmenopausal women, our group previously assessed genotype–phenotype correlation in FFA, phenotyping a large female FFA cohort and demonstrating a causal role for genetic variants implicated in xenobiotic metabolism and antigen presentation 1,2 . Nonetheless, men comprise 3–5% of patients affected by FFA and the male FFA phenotype, including clinical manifestations and comorbidities, has been incompletely characterized in the literature 3–6 . Here, we describe the male FFA phenotype in a case series of 17 men with FFA presenting to St John’s Institute of Dermatology, London, UK.…”

Section: Features Male Ffa Data (N = 17) Female Ffa Data (N = 711)amentioning

confidence: 98%

“…Our male FFA cohort was also comparable to several other case series of male FFA, although our participants had a younger median age of onset and less frequent comorbidity with androgenetic alopecia. [3][4][5][6] Interestingly, an excess of autoimmune comorbidity compared with general population estimates was noted, as were signs of male hormone imbalance. 7,8 These observations suggest that male FFA may involve hair-specific autoimmunity and that sex hormone abnormalities may be relevant to its pathogenesis, possibly via their modulation of pathogenic, hair-specific immune responses.…”

mentioning

confidence: 97%

“…1,2 Nonetheless, men comprise 3-5% of patients affected by FFA and the male FFA phenotype, including clinical manifestations and comorbidities, has been incompletely characterized in the literature. [3][4][5][6] Here, we describe the male FFA phenotype in a case series of 17 men with FFA presenting to St John's Institute of Dermatology, London, UK.…”

mentioning

confidence: 99%

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Clinical characteristics of male frontal fibrosing alopecia: a single-centre case series from London, UK

Rayinda

McSweeney

Dand

et al. 2022

British Journal of Dermatology

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QoL, with older patients affected by social isolation and younger ones experiencing anger and shame.Limitations of the study include the fact that both cohorts were derived from tertiary care centres, potentially over-representing severe presentations. Taken together, our results indicate that clinical presentation and age determine patients' morbidity and experience related to morphoea, underscoring the need to assess these factors in evaluation and treatment.

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Section: Features Male Ffa Data (N = 17) Female Ffa Data (N = 711)asupporting

confidence: 80%

contrasting

confidence: 74%

Section: Features Male Ffa Data (N = 17) Female Ffa Data (N = 711)amentioning

confidence: 98%

mentioning

confidence: 97%

mentioning

confidence: 99%

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Clinical characteristics of male frontal fibrosing alopecia: a single-centre case series from London, UK

Rayinda

McSweeney

Dand

et al. 2022

British Journal of Dermatology

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A multicenter descriptive analysis of 270 men with frontal fibrosing alopecia and lichen planopilaris in the United States

Flanagan¹,

Walker²,

Collins³

et al. 2023

Journal of the American Academy of Dermatology

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Frontal Fibrosing Alopecia and Reproductive Health: Assessing the Role of Sex Hormones in Disease Development

Roman,

Petca,

Dumitrașcu

et al. 2024

JPM

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Frontal Fibrosing Alopecia (FFA) is a distinctive form of cicatricial alopecia characterized by gradual hairline recession, predominantly affecting postmenopausal individuals, thus implying a potential hormonal origin. This narrative review, spanning 2000 to 2023, delves into PubMed literature, focusing on the menopausal and hormonal status of women with FFA. The objective is to unravel the intricate nature of FFA and its plausible associations with hormonal dysregulations in women. While menopause remains a pivotal demographic characteristic linked to FFA, existing data suggest that its hormonal imbalances may not fully account for the development of FFA. Conversely, substantial evidence indicates a strong association between a reduction in fertile years, particularly through surgical interventions leading to an abrupt hormonal imbalance, and FFA in women. Additionally, exposure to hormone replacement therapy or oral contraceptives has shown varying degrees of association with FFA. Gynecologists should maintain a heightened awareness regarding the ramifications of their interventions and their pivotal role in overseeing women’s fertility, recognizing the potential influence on the progression of FFA. The recurrent theme of hormonal disruption strongly implies a causal connection between alterations in sex hormones and FFA in women. Nevertheless, this relationship’s extent and underlying mechanisms remain subjects of ongoing debate.

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Clinical features and sex hormone profile in male patients with frontal fibrosing alopecia: A multicenter retrospective study with 33 patients

Cited by 4 publications

References 5 publications

Clinical characteristics of male frontal fibrosing alopecia: a single-centre case series from London, UK

Clinical characteristics of male frontal fibrosing alopecia: a single-centre case series from London, UK

A multicenter descriptive analysis of 270 men with frontal fibrosing alopecia and lichen planopilaris in the United States

Frontal Fibrosing Alopecia and Reproductive Health: Assessing the Role of Sex Hormones in Disease Development

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