Frontal Fibrosing Alopecia: A Retrospective Study of 75 Patients

Cid, Paola Maldonado; Dosil, V. M. Leis; Gutiérrez, C. Garrido; Moreno, Silvia Salinas; Vasallo, Israel John Thuissard; Vázquez, Castán; Díaz, Rosa

doi:10.1016/j.adengl.2020.03.014

Cited by 8 publications

(20 citation statements)

References 27 publications

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“…-incl. Dutasteride Ankle swelling, acute urticaria [83], digestive intolerance [80], hyperpigmentation on the face and the hands (very rare, in association with pimecrolimus) [102].…”

Section: α-Reductase Inhibitors (5α-ris)mentioning

confidence: 99%

Frontal Fibrosing Alopecia – a review and a practical guide for clinicians

Kępińska¹,

Jałowska²,

Bowszyc‐Dmochowska³

2021

Ann Agric Environ Med.

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Despite a significant increase in reported cases of frontal fibrosing alopecia (FFA) in literature, discussion about the possible role of environmental factors, instruction for diagnosis and guideline for treatment, are limited. The review aims to provide a detailed synthesis of this condition that could be used by clinicians in their practise. Whether single-centre or multicentre, studies of more than 60 cases less than 5 years old were mainly taken into consideration. Results obtained were that FFA affects mainly postmenopausal Caucasian women; the most common comorbidities are hyperlipidaemia, arterial hypertension, osteoporosis, hypothyroidism, depression, alongside dermatological disorders such as atopic dermatitis, rosacea, seborrheic dermatitis and androgenetic alopecia. Autoimmune, genetic, hormonal (e.g. estrogen deficiency, pregnancy, lactation, HRT and raloxifene) and environmental (e.g. daily use of facial sunscreens and less frequent use of hair dyes and shampoo) hypotheses were proposed for pathogenesis, as well as association with various predisposing factors (patient's health-social profile, disease's history and comorbidities). Clinical presentation of FFA can be divided into 3 specific patterns, each with a different prognosis. Diagnosis is usually made clinically with the use of trichoscopy; however, scalp biopsy remains the gold standard. The condition is regarded as a variant of lichen planopilaris (LPP) due to the similarity of the prominent histopathological findings, but the clinical image is distinct and therapeutic options vary. 5α-reductase inhibitors, intralesional steroids, and hydroxychloroquine provide the highest level of evidence for the treatment of FFA. The conclusion is that a better understanding of the disease is crucial for proper disease management.

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“…-incl. Dutasteride Ankle swelling, acute urticaria [83], digestive intolerance [80], hyperpigmentation on the face and the hands (very rare, in association with pimecrolimus) [102].…”

Section: α-Reductase Inhibitors (5α-ris)mentioning

confidence: 99%

Frontal Fibrosing Alopecia – a review and a practical guide for clinicians

Kępińska¹,

Jałowska²,

Bowszyc‐Dmochowska³

2021

Ann Agric Environ Med.

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“…6 Alefacept, interrupting T-cell co-stimulation and depleting T cells, is also an immunosuppressive drug currently used for the treatment of plaque psoriasis. 7 Another link between hyperglycaemia and psoriasis could be related to the advanced glycation end products (AGEs), oxidant and biologically reactive compounds, produced through oxidation of sugars and increased in case of hyperglycaemia. Diabetes mellitus is generally characterized by an excessive accumulation of AGEs in skin and blood.…”

Section: Prevalence Of Psoriasis In a Cohort Of Children And Adolesce...mentioning

confidence: 99%

“…We found a lower rate of eyebrow involvement in men compared with the respective figures in the so far most important case series on female FFA, as well as a lower frequency of facial papules. [5][6][7] Loss of sideburns as an early sign of FFA has originally been reported in males. 8 In our experience, loss of peripheral body hair, specifically anterolateral leg-like alopecia, has been a frequent presenting complaint in males.…”

mentioning

confidence: 99%

Male frontal fibrosing alopecia: study of 35 cases and association with sunscreens, facial skin and hair care products

Westphal¹,

Caballero-Uribe

Régnier

et al. 2021

Acad Dermatol Venereol

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BW/day). 8 In TEN, cessation of the causing agent, high-dose intravenous immunoglobulins together with systemic steroids are recommended. 9 The prognosis of both conditions is generally very poor: in our patient the severity-of-illness score for TEN (SCORTEN) was 4, predicting a mortality rate of 58.3%. 4,9 In acute grade IV, cutaneous GvHD long term survival (>5 years) is only 5%. 10 We report a TEN-like acute cutaneous GvHD in a stem cell recipient, which caused a diagnostic dilemma as clinical and histopathological findings of TEN and GVHD are overlapping. As therapeutic recommendations differ between these two lifethreatening conditions, a distinction of cutaneous GvHD and TEN is very important. In our case, the presence of painless skin lesions, the distribution and evolvement of the exanthema led us favour the diagnosis of cutaneous GvHD.

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“…5 Zhang et al reported a population composed of 97% females, Kanti et al of 95% females, and Maldonado Cid et al of 97% females. 3,6,7 Recently, a case series of 7 male FFA patients has also been published; however, male patients are still a minority. 8 The result of this study in terms of gender distribution is in alliance with the previous literature: FFA is a disease that predominantly affects females.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Demographic Characteristics and the Factors Related to Eyebrow Involvement in Frontal Fibrosing Alopecia: A Retrospective, Cross-sectional, Single Center Study

Uzunçakmak¹,

Özkoca²,

Aşkın³

et al. 2021

Turkiye Klinikleri J Dermatol

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Frontal fibrosing alopecia (FFA) is a rare subtype of primary cicatricial alopecia leading to the gradual recession of the frontotemporal hairline. Eyebrow and facial hair alopecia commonly accompany the scalp hair loss. The usual FFA patient is a postmenopausal female. The most common comorbid diseases in FFA patients are thyroid diseases. In this retrospective, cross sectional study, we aimed to determine the demographic characteristics of the patients with FFA, prevelance of eyebrow involvement and the factors that are associated with eyebrow involvement at the time of evaluation. Material and Methods: A total of 16 patients who were diagnosed with FFA at our department from January 2010 to January 2020 were enrolled in this study. Demographic features and histopathological data were collected from medical records in our Hair Disorders Policlinic .The statistical analysis was performed with the SPSS-21. Results: A total of 16 patients were included in this study. All of the patients were females. Eyebrow loss was observed in 12 (75%) of our patients. The age of the patients had no statistically significant relationship to the eyebrow involvement (p=0.666). Likewise, there is no statistically significant relationship of disease duration to eyebrow involvement (p=0.668). Eyebrow involvement was also more common (75%) in patients who have comorbidity. Conclusion: Similar to the literature, FFA was found to be more common in postmenopausal female patients in our study. There was no statistically significant relationship between eyebrow loss and the duration of the disease or the age of the patient, but it was striking that the frequency of eyebrow involvement was more common in patients with comorbidities. These data obtained from our study have not been reported in the literature before, and larger patient series are needed to explain the relationship more clearly.

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Frontal Fibrosing Alopecia: A Retrospective Study of 75 Patients

Cited by 8 publications

References 27 publications

Frontal Fibrosing Alopecia – a review and a practical guide for clinicians

Frontal Fibrosing Alopecia – a review and a practical guide for clinicians

Male frontal fibrosing alopecia: study of 35 cases and association with sunscreens, facial skin and hair care products

Evaluation of the Demographic Characteristics and the Factors Related to Eyebrow Involvement in Frontal Fibrosing Alopecia: A Retrospective, Cross-sectional, Single Center Study

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