Familial Frontal Fibrosing Alopecia

Abstract

Frontal fibrosing alopecia (FFA) is an emerging disease in Western countries. We present the cases of three sisters who were referred simultaneously to the Department of Dermatology, Hospital Universitario San Cecilio, Granada, Spain, in 2018. All patients suffered from at least partial frontotemporal hairline recession and eyebrow loss. Following trichoscopic examination, the three sisters were diagnosed with FFA. Only one of the sisters agreed to be treated; she was prescribed with topical clobetasol propionate solution and minoxidil and achieved disease control at the three-month follow-up. These patients represent a new case of familial FFA wherein three sisters as well as their mother were affected by FFA. A systematic review found a total of 24 cases of familial FFA, of which this report is the 25th. In the majority of families, only females were affected (88%) while in the remainder both males and females (8%) were affected; there was only one family where only males were affected (4%). The relationship between the affected individuals was predominately between sisters (56%) followed by mother and daughter (32%). The median age was 61 years old (range: 14–88 years) and the duration of the disease ranged between 3–360 months. Family groups of FFA are an infrequently described phenomenon with unknown prevalence.
 Keywords: Alopecia; Dermatology; Hair Diseases; Case Report; Spain.

Tangled Truths: Unraveling the Link Between Frontal Fibrosing Alopecia and Allergic Contact Dermatitis

“…7 There is some suspicion of genetic susceptibility in the onset of FFA as suggested by familial reports and genome-wide association studies. [8][9][10] Hormonal and autoimmune factors also have been linked to FFA, including an increased risk for thyroid disease and the postmenopausal rise of androgen levels. 6 Allergic Contact Dermatitis and FFA…”

Potential etiological factors in frontal fibrosing alopecia

“…There are 25 familial cases of FFA reported in the literature, involving a total of 59 patients [44]. Recent research is aimed at identifying polymorphisms of human leukocyte antigens (HLA).…”

“…However, the study and its methodology raise a number of doubts, especially considering that other conclusions from this study could indicate that nia przedkliniczne na modelu mysim wykazały, że stymulacja stresem może wywoływać neurogenne zapalenie wokół mieszków włosowych, prowadzić do wzrostu degranulacji komórek tucznych i wytwarzać czynniki hamujące, takie jak substancja P [43]. czynniki genetyczne W piśmiennictwie opisano 25 przypadków rodzinnego występowania FFA obejmujących łącznie 59 pacjentów [44]. Badania ostatniego okresu nakierowane są na próbę identyfikacji polimorfizmów ludzkich antygenów leukocytarnych (HLA).…”

Protein profiling of forehead epidermal corneocytes distinguishes frontal fibrosing from androgenetic alopecia

“…Most frequently found in postmenopausal females, it can occur before menopause as well as infrequently in males. A genetic predisposition seems likely from analysis of familial relationships [19,20], a possibility supported by identification of several genomic loci, including an HLA allele, associated with it by genome wide studies [21]. Lichen planopilaris and FFA have been hypothesized to result from damage to hair follicle stem cells due to an autoimmune inflammatory response upon collapse of immune privilege [22,23].…”

“…Relative expression levels were calculated from log FC values in S3 Table . Proteins are identified by gene names (abbreviated) to avoid ambiguity. (A) Expressed at higher levels in FFA samples are (1) GAPDH, (2) SERPINB12, (3) KRT77, (4) ALOXE3, (5) CAT, (6) KRT19, (7) TXN, (8) BLMH (9) KRT4, (10) GSDMA, (11) PRDX4, (12) HSPD1, (13) CAPNS2, (14) GDPD3, (15) LGALSL, (16) SER-PINB7, (17) GDA, (18) PEBP1, (19)…”