Facial lesions in frontal fibrosing alopecia (FFA): Clinicopathological features in a series of 12 cases

López-Pestaña, A.; Tuneu, Anna; Lobo, Carmen; Ormaechea, Nerea; Zubizarreta, J.; Vildosola, S.; Alcázar, E. del

doi:10.1016/j.jaad.2015.08.020

Cited by 57 publications

(69 citation statements)

References 13 publications

(11 reference statements)

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“…The pathology was consistent with a lichenoid lymphocytic infiltrate of the vellus follicles. However, our findings are most consistent with the work of López-Pestaña et al [2] who described 9 patients with FFA presenting with perifollicular erythema of the forehead, glabella, eyebrows, and cheeks, with clinical images that are similar to the red dots in the net-like pattern on the chest seen in our 2 patients. In fact, their pathologic Figure 3b is identical to our pathologic findings, highlighting an interfollicular lichenoid infiltrate [2] .…”

Section: Discussionsupporting

confidence: 93%

“…The reticular pattern presented on dermoscopy is reminiscent of the reticulated pattern described for lichen planus pigmentosus. In addition, Lópes-Pestaña et al [2] reported on a patient who presented with an erythematous network on the face that gradually evolved into a pigmented network.…”

Section: Discussionmentioning

confidence: 99%

“…The hair loss in FFA can be more generalized, involving the eyebrows, sideburns, limbs, and other body areas [1]. Facial lesions have been reported in patients with FFA consisting of noninflammatory, skin-colored papules [2,3,4], perifollicular or diffuse erythema [2], glabellar red dots [1], progressive pigmented macules, and lichen planus pigmentosus [2]. Ramanauskaite and Trüeb [5 ]reported a case of skin-colored facial papules attributing to roughening of the skin in a patient with FAPD.…”

Section: Figmentioning

confidence: 99%

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Red Dots in a Net-Like Pattern on the Upper Chest: A Novel Clinical Observation in Frontal Fibrosing Alopecia and Fibrosing Alopecia in Pattern Distribution

Billero

Oberlin

Miteva

2017

Skin Appendage Disord

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Figmentioning

confidence: 99%

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Red Dots in a Net-Like Pattern on the Upper Chest: A Novel Clinical Observation in Frontal Fibrosing Alopecia and Fibrosing Alopecia in Pattern Distribution

Billero

Oberlin

Miteva

2017

Skin Appendage Disord

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“…Facial lesions in FFA were first described by Abbas et al [11] in 2007, when he showed facial papules due to the involvement of vellus hair [12]. Later, in 2013, Dlova [5] reported her cases of facial LP pigmentosus associated with FFA; in 2014, Pirmez et al [13] described follicular red dots in the glabellar and forehead areas, and, in 2015, López-Pestaña et al [12] reported perifollicular and diffuse erythema and the gradual appearance of pigmented macules on facial skin, whose biopsies showed perifollicular and interfollicular lichenoid infiltrate.…”

Section: Discussionmentioning

confidence: 99%

“…Later, in 2013, Dlova [5] reported her cases of facial LP pigmentosus associated with FFA; in 2014, Pirmez et al [13] described follicular red dots in the glabellar and forehead areas, and, in 2015, López-Pestaña et al [12] reported perifollicular and diffuse erythema and the gradual appearance of pigmented macules on facial skin, whose biopsies showed perifollicular and interfollicular lichenoid infiltrate. The description of facial lesions in FFA shows us that FFA is not restricted to the scalp and that facial involvement can be the first sign of FFA, which allows us to make an early diagnosis of FFA.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Histopathological Findings of Frontal Fibrosing Alopecia-Associated Lichen Planus Pigmentosus

Romiti

Gavioli

Anzai

et al. 2017

Skin Appendage Disord

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Background: Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia occurring mainly in postmenopausal women. A range of facial lesions have been described in FFA, such as lichen planus (LP) pigmentosus, red dots, facial papules, and perifollicular and diffuse erythema. These lesions can be the first sign of FFA. LP pigmentosus is a rare variant of LP. The first description of LP pigmentosus associated with FFA (in 2012) reported 22 cases of LP pigmentosus among 44 cases of FFA affecting South African patients. Methods: We reviewed 16 FFA patients with LP pigmentosus and the histopathological findings of the biopsy of LP pigmentosus in 9 patients. Results: Most patients had intermediate skin phototypes (III-IV; n = 10; 62%). The age at onset of LP pigmentosus ranged from 30 to 60 years. The most common histopathological findings were epidermal atrophy, basal cell degeneration, interfollicular inflammatory infiltrate and melanophages, and perifollicular changes. Other findings not previously described in LP pigmentosus were inflammation and interface changes on sweat duct epithelia (acrosyringium and superior dermal duct), and lichenoid perisebaceitis. Conclusions: Histology of our cases confirmed previous findings and showed a high incidence of perifollicular involvement with occasional changes affecting sebaceous and sweat glands.

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An Indurated Plaque on the Eyelid

Chen

Yao

2020

JAMA Dermatol

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A man in his 60s presented with a 1-year history of a pruritic, dark red plaque on his right upper eyelid. No remarkable medical history was noted. Physical examination findings revealed a 4 × 2-cm erythematous, violaceous, indurated, scaly plaque with some papules on his right upper eyelid (Figure , A). Results of routine blood tests and biochemistry analysis were within normal limits. A biopsy sample was obtained for histopathologic examination (Figure , B).Histopathologic analysis revealed perifollicular lymphocytic infiltrates around cystically dilated follicular infundibula and exocytosis of atypical lymphocytes into the epithelium, with admixed plasma cells, eosinophils, and multinucleate giant cells (Figure , C). Alcian blue staining showed focal mild follicular mucin deposition. Immunohistochemical analysis showed lymphocytic infiltrates positive for CD3, CD4, CD5, and CD7 and negative for CD8, CD20, CD30, CD79a, and CD56 (Figure , D). The ratio of CD4 to CD8 cells within hair follicles was greater than 7:1. Monoclonal T-cell gene rearrangement was demonstrated.

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Facial lesions in frontal fibrosing alopecia (FFA): Clinicopathological features in a series of 12 cases

Cited by 57 publications

References 13 publications

Red Dots in a Net-Like Pattern on the Upper Chest: A Novel Clinical Observation in Frontal Fibrosing Alopecia and Fibrosing Alopecia in Pattern Distribution

Red Dots in a Net-Like Pattern on the Upper Chest: A Novel Clinical Observation in Frontal Fibrosing Alopecia and Fibrosing Alopecia in Pattern Distribution

Clinical and Histopathological Findings of Frontal Fibrosing Alopecia-Associated Lichen Planus Pigmentosus

An Indurated Plaque on the Eyelid

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