Photopatch and patch testing in 63 patients with frontal fibrosing alopecia: a case series

Rocha, Vanderson; Donati, Aline; Contin, Letícia Arsie; Kakizaki, Priscila; Machado, Carla Jorge; Brito, Fernanda Freitas de; Claudino, D.; Moraes, Paola Castro; Guerra, Juliana Elvira Herdy; Pires, Mário Cézar

doi:10.1111/bjd.16933

Cited by 23 publications

(18 citation statements)

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“…In the same way, benzyl salicylate may cross react with Myroxylon pereirae, which could explain the positive reactions to it in some of our patients as well as in previously published series. [1][2][3][4][5] The association of benzyl salicylate and octyl gallate is less clear. One possible explanation is the exposure to both in a common source (cosmetics, food, or other).…”

Section: Discussionmentioning

confidence: 99%

“…1 After this research, other studies in different countries also found frequent contact sensitization among patients with FFA (up to 76%) (Online supplemental Table S1). [2][3][4][5] In a recent article by Prasad, a surprisingly high frequency of sensitization to gallates as well as to other allergens was found. 5 To evaluate the frequency of sensitization/photosensitization, the most frequent positive allergens and the frequency of clinical history of dermatitis among an FFA population the following retrospective analysis was performed.…”

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confidence: 99%

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Sensitization to benzyl salicylate and other allergens in patients with frontal fibrosing alopecia

et al. 2021

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Background: Contact sensitization is frequent among patients with frontal fibrosing alopecia (FFA) (52%-76%).Objective: To evaluate the frequency of sensitization/photosensitization in an FFA population.Methods: A population of FFA patients were patch tested (Spanish Contact Dermatitis Research Group [GEIDAC] baseline; cosmetic and fragrance series), and photopatch tested (sunscreen series).Results: Thirty-six patients (mean age: 64.6 years; 35/36: women) were studied. A history of dermatitis was recorded in 69.4% (frequently involving the face). Overall, 80.5% patients showed positive patch-test reactions. The most frequently positive allergens were nickel sulfate (25%), benzyl salicylate (22%), gallates (16.6%), propolis (16.6%), and limonene hydroperoxides (13.8%). Benzyl salicylate was likely relevant to the dermatitis (labeled on personal care products and most patients reporting clinical improvement with allergen avoidance). Patch tests with sunscreens showed positive reactions to 11 materials (five patients). Photopatch tests were positive in one case. Conclusion:We speculate a possible relationship between sensitization to benzyl salicylate and FFA. Hypothetically, the most likely explanation is that sensitization to benzyl salicylate involving FFA patients is a consequence of increased exposure to it.It is unclear whether allergen avoidance may impact the prognosis of alopecia. However, it seems to significantly improve the patients´quality of life by lessening dermatitis and pruritus. K E Y W O R D S allergic contact dermatitis, benzyl salicylate (CAS no. 118-58-1), fragrance, frontal fibrosing alopecia, gallates, patch tests, photopatch tests, propolis, scarring alopecia, sunscreen 1 | INTRODUCTION Frontal fibrosing alopecia (FFA) is an inflammatory type of alopecia in which lichenoid lymphocytic infiltrates lead to perifollicular fibrosis and irreversible loss of follicles. It mainly concerns the frontal, The authors do not have any conflicts of interest to declare.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Sensitization to benzyl salicylate and other allergens in patients with frontal fibrosing alopecia

et al. 2021

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“…36 In contrast, Rocha and colleagues in another study assessed the photopatch and patch testing in 63 patients with FFA and did not demonstrate an association of FFA with photoallergy to several cosmetic-related substances. 37…”

Section: Resultsmentioning

confidence: 99%

“…In their study, Aldoori and colleagues evaluated the leave‐on facial skin care products and sunscreens and demonstrated that there is an association between FFA and the use of facial skin care products including facial skin care ones 36 . In contrast, Rocha and colleagues in another study assessed the photopatch and patch testing in 63 patients with FFA and did not demonstrate an association of FFA with photoallergy to several cosmetic‐related substances 37 …”

Section: Discussionmentioning

confidence: 99%

Allergic contact dermatitis in patients with frontal fibrosing alopecia: An international multi‐center study

Rudnicka

Rokni

Lotti

et al. 2020

Dermatologic Therapy

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Frontal fibrosing alopecia (FFA) mainly affects the anterior hairline and eyebrows and its etiology and associated factors remain obscure. The aim of this study was to evaluate the allergic contact dermatitis with patch test in patients with FFA. In this prospective study, 20 patients with FFA and 24 age and sex‐matched healthy individuals were evaluated with patch testing. Diagnosis was made histologically, clinically and based on dermoscopic findings. Demographic data, age of onset, disease duration and FFA severity index are evaluated in all patients. Positive patch test reaction to one or more allergen was observed in 65% of patients while it was 37.5% in control group (P = .003). There was a significant difference between age (P = .006) and positive patch test results. No statistical significant difference was observed in the results of patch testing and disease duration (P = .519), menopausal status (P = .085), and FFA severity index (P = .573). Our findings suggest an association between FFA and allergic contact dermatitis. The utility of patch testing in FFA patients can explore the role of allergic etiology and may have an enormous impact on the diagnostic potential and quality of life of these patients.

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“…Contact allergy to hair dye and a higher concentration of hair dye products on the anterior hairline with the initial stroke of application, with reducing gradient posteriorly could explain the preferential involvement of the anterior hair margin in FFA [18]. The increased fragrance allergy and photosensitivity complaint were also found, although the authors did not confirm the association of FFA with photoallergy to several cosmetic-related substances [14,19,20]. Brunet-Possenti et al suggested that the reasons for the high frequency of positive patch tests may be an extensive use of cosmetics in this group, or an altered immune response.…”

Section: Etiopathogenesismentioning

confidence: 92%

Frontal fibrosing alopecia: a disease that remains enigmatic

Lis‐Święty

Brzeźińska-Wcisło

2020

pdia

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Frontal fibrosing alopecia (FFA) is recognized to represent a generalized process of inflammatory scarring alopecia. Apart from the classic form affecting the frontal hairline, there are a range of disease manifestations involving loss of eyebrows and of eyelashes, loss of peripheral body hair, fibrosing alopecia in a pattern distribution, facial and extrafacial skin, mucous membrane, and nail involvement. Classic linear, diffuse "zigzag", pseudo "fringe sign", androgenetic alopecia-like, cockade-like, ophiasis-like and incomplete patterns are distinguished. The aetiology of FFA remains obscure, but a number of pathogenetic hypotheses and treatments to halt disease progression have been proposed.

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Photopatch and patch testing in 63 patients with frontal fibrosing alopecia: a case series

Cited by 23 publications

References 9 publications

Sensitization to benzyl salicylate and other allergens in patients with frontal fibrosing alopecia

Sensitization to benzyl salicylate and other allergens in patients with frontal fibrosing alopecia

Allergic contact dermatitis in patients with frontal fibrosing alopecia: An international multi‐center study

Frontal fibrosing alopecia: a disease that remains enigmatic

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