<p>Optimal Management of Frontal Fibrosing Alopecia: A Practical Guide</p>

Abstract

Frontal fibrosing alopecia (FFA) is a primary lymphocytic cicatricial alopecia that is often considered a clinical variant of lichen planopilaris (LPP) due to their shared histopathologic features. FFA is characterized by the recession of the frontal, temporal, or frontotemporal hairline; the clinical pattern is distinct and usually includes eyebrow hair loss, as well as other associated symptoms. Pruritus, facial papules, eyelash loss, body hair involvement, and trichodynia may also occur in addition to the frontotemporal recession and eyebrow loss classically seen. Early diagnosis and prompt treatment are critical as FFA is a progressive disorder that can result in permanent hair loss. FFA is challenging as patients may not present or be recognized until the disease has progressed. Additionally, there is currently no consensus or standard treatment regimen for FFA. While many different therapies have been reported as beneficial, there are a limited number of published guidelines for the treatment of FFA. This article is a review of the literature on treatment modalities for FFA and the objective is to offer a practical guide for clinicians on the evidence-based management options currently available in the literature.

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

“…Adapted from Gamret, Potluri, Krishnamurthy et al [5], Ho and Shapiro [27], Imhof and Tolkachjov [68], and Rácz, Gho, Moorman et al [6]. Citations: Hydroxychloroquine.…”

“…Note: Adapted from Gamret, Potluri, Krishnamurthy et al [5], Ho and Shapiro [27] and Imhof and Tolkachjov [68]. [65].…”

“…To sum up, the highest level of evidence for the treatment of FFA is currently provided by 5α-RIs, intralesional steroids, and hydroxychloroquine [5,27,68] (Tab. 6).…”

“…6). Unlike LPP, FFA shows poor response to topical and systemic steroids and other immunosuppressives [27,54,68] (Tab. 1, Tab.…”

“…For those more interested in details of the treatments reported in the literature, the treatment reviews for FFA made by Gamret, Potluri, Krishnamurthy et al [5], Ho and Shapiro [27], Imhof and Tolkachjov [68] and Rácz, and Gho, Moorman et al, are highly recommended [6]. An updated synthesis of their works is presented in Table 6 and should be considered next to the adverse effects reported in Table 7.…”