Perifollicular erythema as a trichoscopy sign of progression in frontal fibrosing alopecia

Abstract

Introduction:Frontal fibrosing alopecia (FFA) in an entity characterized by the recession of the frontotemporal hairline (FTHL) with alopecic scarring change. In recent years there are numerous articles discussing the usefulness of dermoscopy for the clinical diagnosis of different types of scarring alopecia.Materials and Methods:We value 79 patients diagnosed with FFA, evaluating some trichoscopical findings described as typical for FFA: Absence of follicular opening, follicular hyperkeratosis, follicular plugs and erythema.Results:In a population of 79 women, 100% showed no follicular opening, 72.1% follicular hyperkeratosis, 66.3% perifollicular erythema and 44.8% follicular plugs. Thus, 100% of patients had at least one of the dermoscopic elements described as suggestive of FFA, 53% two of them, 45% three and 27%, all those elements. Perifollicular erythema was present in 95% of cases in which the disease was active.Conclusions:We consider that the presence of perifollicular erythema will be a direct marker of FFA activity.

Two different trichoscopic patterns of mid-frontal scalp in patients with frontal fibrosing alopecia and clinical features of androgenetic alopecia

“…Perifollicular erythema was described as a direct marker of FFA activity [13]. According to our results, in patients with FFA, mid-frontal scalp hair loss with clinical presentation similar to FPHL is observed (53% of FFA patients in our study).…”

“…Trichoscopy findings of the frontotemporal line in patients with FFA include minor perifollicular scaling, areas with a lack of follicular units (these features are characteristic for LPP) and presence of lonely hairs [12][13][14]. Perifollicular erythema was described as a direct marker of FFA activity [13].…”

Journal of Surgical Dermatology Volume 1 Issue 2: Full Issue

“…Moreover, there is a clear gap in clinician knowledge of CHG incompatibility. According to a survey in Washington State, a cohort of only 48% health personnel was aware of CHG inactivation by some topical anionic moisturizers [38] . This survey illustrated a need for further education and research on CHG incompatibility with selected concurrently used topical agents.…”

“…In cases of melasma, KTP functions by generating gentle heat in melanosomes with long pulses (millisecond) rather than causing mechanical destruction of the target chromophores. KTP lasers greatly reduce redness and pigmentation compared to Nd:YAG lasers in patients requiring skin rejuvenation [38] .…”

Hair Transplantation for Frontal Fibrosing Alopecia: Part of the Solution?

“…The usefulness of performing trichoscopy to monitor disease activity and response to therapy cannot be emphasised enough: look for the presence of perifollicular hyperkeratosis/desquamation and perifollicular erythema, which are correlated with disease activity in FFA. 10 Regarding the maintenance medical treatment to be prescribed after hair transplantation for FFA, clobetasol propionate 0.05% lotion twice a week could be considered as a possible maintenance scheme; from our clinical practice experience, the risk of adverse effects with this regimen appears to be very small. As an alternative, a topical calcineurin inhibitor such as tacrolimus 0.1% ointment or pimecrolimus 1% cream could also be considered (tolerability: pimecrolimus > tacrolimus).…”