Frontal fibrosing alopecia: a retrospective clinical review of 62 patients with treatment outcome and long‐term follow‐up

Abstract

Frontal fibrosing alopecia is increasingly seen in postmenopausal women and rarely in men. Despite the limitations of a retrospective study, we conclude early intervention and treatment with intralesional triamcinolone acetonide may halt the progression of the disease; however, further controlled prospective studies are needed to establish treatment guidelines for frontal fibrosing alopecia.

Examination of Clinical and Demographic Characteristics of 14 Cases with Frontal Fibrosing Alopecia

“…Today, FFA is regarded as a clinical variant of LPP which has selectivity for frontotemporal hairline, primarily affects postmenopausal women and is characterized by lymphocytic cicatricial alopecia (2,3,17). Some authors detected lichen planus lesions in patients with FFA (15,19). Furthermore, due to premenstrual female cases with normal levels of sex hormones with accompanying lichen planus lesions, some authors also supported the opinion that the disease is a clinical variant of LPP rather than being an androgen-based disease (11,17).…”

“…Symptoms such as itching, burning and pain are seen less compared to lichen planopilaris. Itching on FFA area was reported in 3-67% of the cases in the literature (4,6,11,13,15). Itching was present in 21% of the cases (3 cases).…”

“…Eyebrow loss and thinning is frequent, and helps to make diagnosis. Thinning or total loss of the eyebrows was reported in 50-95% of the FFA cases (6,12,13,15). Vona et al stated that eyebrow loss is present in moderate-severe cases (14).…”

“…Other cases had normal distribution of body hair. In the early stages of the disease, presence of perifollicular inflammatory papule or erythema was reported in 31-73% of the cases on the progression region of the disease (6,13,15). While most cases had perifollicular erythema, only 2 cases (14.2%) had perifollicular hyperkeratosis.…”

“…Case reports and series were reported in local and foreign literature (10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Here, we aimed to present the demographic, clinical and laboratory characteristics of female patients diagnosed and followed-up with FFA in our clinic by comparing these with the literature data.…”