Hypopigmentation of the Eyebrows in Frontal Fibrosing Alopecia

Salas‐Callo, Corina Isabel; Cajas-García, María Salomé; Pirmez, Rodrigo

doi:10.1159/000512866

Cited by 3 publications

(2 citation statements)

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“…On the basis of recent studies and as depicted in Figure 3 a , intracutaneous pathobiology elements and locally active environmental factors seem to be the key factors in the development of both LPP and FFA ( Chiang et al., 2015 , 2012 ; Harries et al., 2020 , 2018 ). Such environmental factors may include skin trauma due to hair transplantation (triggering LPP development) and/or face lift surgery (inducing FFA) ( Chiang et al., 2012 ; Lee et al., 2021 ; Vañó-Galván et al., 2019b ), psychoemotional stress and stress mediators (e.g., substance P [SP] induces neurogenic inflammation and immune privilege [IP] collapse of human scalp HFs [ Peters et al., 2007 ], whereas noradrenaline can induce the proliferation and thus exhaustion of HF melanocytes stem cells (SCs) in mice [ Zhang et al., 2020 ]; indeed, LPP and FFA HFs show loss of melanocytes [ Lin et al., 2017 ; Salas-Callo et al., 2021 ]), and certain leave-on cosmetics whose relevance in FFA is currently intensely being debated ( Aldoori et al., 2016 ; Debroy Kidambi et al., 2017 ; Strazzulla et al., 2017 ). All these may trigger the recruitment of a pathogenic immune cell infiltrate to the HF, possibly along with dysbiosis of the HF microbiome ( Constantinou et al., 2021b ; Lousada et al., 2021 ), thus further perpetuating the perifollicular inflammation.…”

Section: Conceptual Pathobiology Considerationsmentioning

confidence: 99%

Frontiers in Lichen Planopilaris and Frontal Fibrosing Alopecia Research: Pathobiology Progress and Translational Horizons

et al. 2022

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Section: Conceptual Pathobiology Considerationsmentioning

confidence: 99%

Frontiers in Lichen Planopilaris and Frontal Fibrosing Alopecia Research: Pathobiology Progress and Translational Horizons

et al. 2022

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“…Frontal fibrosing alopecia (FFA) is a primary scarring lymphocytic alopecia, characterized by a progressive recession of the frontotemporal hairline. 1 Clinically, it may develop with cutaneous hypopigmentation in the affected areas of the scalp and eyebrows, 2,3 which has been associated with a reduction in the epidermal melanocyte count. 2 Peripilar white halos observed under trichoscopy have been associated with fibrosis in other scarring alopecias.…”

Section: Introductionmentioning

confidence: 99%

Follicular Melanocytes in Frontal Fibrosing Alopecia: An Immunohistochemical Study With Trichoscopic Correlation

Salas‐Callo¹,

Quintella

Saceda‐Corralo

et al. 2021

The American Journal of Dermatopathology

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Background:Frontal fibrosing alopecia (FFA) is a scarring alopecia that affects the frontotemporal hairline. Clinically, it may develop with cutaneous hypopigmentation of the affected areas, which has been associated with a reduction in the epidermal melanocyte count. In trichoscopy, peripilar white halos can be observed, which have been associated with fibrosis in other scarring alopecias.Objective:To evaluate the trichoscopic, histopathological and immunohistochemical characteristics of the peripilar white halos in FFA patients.Materials and methods:We conducted a descriptive cross-sectional study that included 12 patients with FFA presenting peripilar white halos. Two 2-mm punch trichoscopy-guided biopsies were performed in all patients, one fragment for vertical section and another for horizontal section. The vertical sections were stained with Fontana-Mason and Melan-A.Results:On trichoscopic examination, peripilar white halos ≤ 1 mm in size were observed on the affected scalp. In vertical sections, a reduction in basal melanin pigmentation and a decrease in the melanocyte count in the upper segment of the hair follicle were observed with Fontana-Masson staining and Melan-A immunostaining, respectively.Limitations:The small sample size and absence of a control group.Conclusion:This study shows follicular melanocyte involvement in FFA, and this finding may be associated with the peripilar white halos observed in trichoscopy.

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Trichoscopy of Frontal Fibrosing Alopecia Affecting Black Scalp: A Literature Review

Souza,

Cortez de Almeida,

Melo

2024

Skin Appendage Disord

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Background: Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia characterized by progressive recession of the frontotemporal hairline, affecting mainly postmenopausal and, lately, premenopausal women of African descent. Considering the importance of trichoscopy on FFA diagnosis and the peculiarities found in patients with higher skin phototypes, this study aimed to review the FFA trichoscopy in the black scalp (Fitzpatrick IV–VI), a topic that remains sparsely described in the existing literature. Summary: In black patients, FFA may manifest singular features on presentation posing diagnostic clinical and trichoscopic challenges. This group has lower prevalence of the FFA compared to other alopecias. It may have an earlier age of onset and often exhibits more severe manifestations due to the coexistence of other types of alopecia and delay in diagnosis. The early signs of the disease in black patients may manifest in the eyebrows before scalp hair loss and lichen planus pigmentosus may be a herald sign. Key Messages: Our research analyzes FFA trichoscopy findings in black patients to help precise diagnosis and treatment. Raising awareness of the disease characteristics on trichoscopy contributes to improving hair care in this population.

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Hypopigmentation of the Eyebrows in Frontal Fibrosing Alopecia

Cited by 3 publications

References 3 publications

Frontiers in Lichen Planopilaris and Frontal Fibrosing Alopecia Research: Pathobiology Progress and Translational Horizons

Frontiers in Lichen Planopilaris and Frontal Fibrosing Alopecia Research: Pathobiology Progress and Translational Horizons

Follicular Melanocytes in Frontal Fibrosing Alopecia: An Immunohistochemical Study With Trichoscopic Correlation

Trichoscopy of Frontal Fibrosing Alopecia Affecting Black Scalp: A Literature Review

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