Frontal fibrosing alopecia and genital Lichen sclerosus: Single‐center experience

Abstract

Background Despite the incidence of Frontal fibrosing alopecia (FFA) has been increasing in last two decades, the pathophysiology and trigger factors of FFA have not been yet fully understood. Aims The aim of this study was to describe epidemiology, clinical and trichoscopic features and comorbidities of FFA patients, in order to improve the understanding of this disease. Patients/Methods A retrospective, observational monocentric study was conducted from 2003 to 2019. Data concerning epidemiology (age, gender, age of menopause, and age of FFA onset), comorbidities, current therapies, localization of FFA (such as frontotemporal hairline, occipital, eyebrow, eyelash, beard, sideburns, and body hair), presence of papules and sign of Lichen planus (LP) at skin, mucosae and/or nail were collected for each patient included. Results A total of 119 Caucasian, adult patients (8 men and 111 female) with FFA were enrolled in the study. Cutaneous, mucosal, or nail localization of LP were found in 16% of our subjects. Interestingly, 15 out of 119 subjects (10.61%) were affected by concomitant genital Lichen sclerosus (LS) and 5 out of these 15 patients (4.38%) presented both LS and LP in association with FFA. Conclusion Considering the high prevalence of LS in FFA patients in our case series, and the frequency of autoimmune comorbidities in both LS and FFA, it is possible to hypothesize an autoimmune process in both conditions. Further studies are needed for a better understanding of the nature of the association between LS and FFA.

Clinical and Dermoscopic Approaches to Diagnosis of Frontal Fibrosing Alopecia: Results From a Multicenter Study of the International Dermoscopy Society

“…and 2021 [30][31][32][33][34]. In 13 studies, clinical and trichoscopic features were decisive for the diagnosis in almost all FFA cases [26,30,34,39,[42][43][44][45][46][47][48][49]. Invasive biopsies for histopathological examinations were reserved for doubtful cases and confirmed the diagnosis in all cases.…”

“…and 2021 [30][31][32][33][34]. In 13 studies, clinical and trichoscopic features were decisive for the diagnosis in almost all FFA cases [26,30,34,39,[42][43][44][45][46][47][48][49].…”

“…)[19,[25][26][27][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49].During 2014During , 2015, and 2016 only one study was published per year[25,48,49]. Two and 5 studies were published in 2017 and…”

Vulvar Lichen Sclerosus from Pathophysiology to Therapeutic Approaches: Evidence and Prospects

“…Several lines of evidence suggest a pivotal role of autoimmunity in VLS pathogenesis. A higher percentage of VLS patients, when compared with controls, have one or more autoimmune-related disease or a family history of autoimmune disease or autoimmune antibodies [53][54][55][56][57][58][59][60]. Thyroiditis, alopecia areata, vitiligo and pernicious anaemia are the most common autoimmune diseases diagnosed in patients with VLS.…”

Frontal fibrosing alopecia: An overview

“…[7] e diseases that are seen in association with FFA as documented in literature are lichen planopilaris, lichen planus, chronic cutaneous lupus erythematosus, thyroid abnormality (mostly hypothyroidism), vitiligo, Sjogren's syndrome, rosacea, and genital lichen sclerosus. [4,[8][9][10][11][12] Katoulis et al reported a 72-year-old woman and a 48-year-old man who developed FFA on pre-existing vitiligo of the forehead. [11] ere are reports of coexistence of FFA with other non-scarring alopecias such as androgenetic alopecia, alopecia areata, and trichotemnomania (an obsessive compulsive habit where the patient cuts or shaves one's own hair).…”