Frontal Fibrosing Alopecia and Vitiligo: Coexistence or True Association

Abstract

Frontal fibrosing alopecia (FFA) is a primary lymphocytic cicatricial alopecia characterized by a progressive band-like recession of the frontotemporal hairline and frequent loss of the eyebrows. It predominantly affects postmenopausal women. Coexistence of FFA and vitiligo is rarely reported in the literature. We retrospectively studied 20 cases diagnosed with FFA in a 14-month period in our Department. Among them, there were 2 cases, a 72-year-old woman and a 48-year-old man, who developed FFA on preexisting vitiligo of the forehead. Anatomical colocalization of the two dermatoses supports the notion that a causal link may exist and their association may not be coincidental. We suggest that interrelated immunologic events and pathologic processes may underlie both these skin conditions.

Frontal fibrosing alopecia: a case series of 65 patients seen in a single Italian centre

“…We found a strong association between FFA and LPP, which were associated in almost 1/4 of the patients, suggesting that FFA represents a clinical variant of LPP, with an autoimmune pathogenesis. According to literature, 3,[12][13][14][15][16][17] we found a significant prevalence of other autoimmune diseases (50.8%) in our patients and a high percentage of patients with atopic background (35.4%), suggesting a possible personal predisposition to immune system disorders.…”

Frontal fibrosing alopecia: is the melanocyte of the upper hair follicle the antigenic target?

“…In a retrospective study of 20 cases diagnosed with FFA at our Academic Department during a 14‐month period, there were two patients, a 72‐year‐old female and a 48‐year‐old male, who developed FFA on preexisting vitiligo of the forehead. Anatomical colocalization supports the hypothesis that a causal link may exist, in terms of interrelated immunologic events and pathologic processes that may underlie both these skin conditions . Furthermore, we studied prospectively 27 females (mean age 67 years) with FFA and found that eight (29.6%) had autoimmune thyroiditis with positive anti‐thyroid autoantibodies, and five (18.5%) had subclinical hypothyroidism with negative autoantibodies…”

Frontal fibrosing alopecia – review of recent case reports and case series in PubMed

“…0.2–0.5 %). Individual case reports and small case series have repeatedly suggested that FFA may be associated with vitiligo . Whether this is merely a coincidence or a genuine association has not been conclusively elucidated.…”