The Use of Direct Immunofluorescence in Frontal Fibrosing Alopecia

Donati, Aline; Gupta, Aditya K.; Jacob, Chandni Maria; Cavelier‐Balloy, B.; Reygagne, P.

doi:10.1159/000469665

Cited by 11 publications

(9 citation statements)

References 9 publications

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“…Furthermore, concentric lamellar fibroplasia seems to be more frequently present in LPP than in FFA, while the presence of terminal catagen-telogen hairs is more frequently found in FFA [ 182 ]. The presence of direct immunofluorescence deposits is more frequent in LPP [ 167 , 184 ]; in FFA, it is usually negative, although IgM deposits over the basement membrane and cytoid bodies in the papillary dermis have been described [ 133 , 185 ]. Moreover, the epidermis is thinner in FFA than in LPP [ 30 ]; this reduction in the epidermal thickness (and also dermal) has been noted in the alopecic band of FFA naïve patients [ 174 ].…”

Section: Are Lpp and Ffa The Same Disease?mentioning

confidence: 99%

Frontal Fibrosing Alopecia: A Review

Porriño‐Bustamante

Fernández‐Pugnaire

Arias‐Santiago

2021

JCM

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Frontal fibrosing alopecia is a scarring alopecia, the prevalence of which is increasing worldwide since its first description in 1994. The reason for this emerging epidemic may be a higher exposure to an unknown trigger, although its aethiology and pathogenesis still remain enigmatic. Clinical, trichoscopic, sonographic, and histopathologic findings are allowing clinicians to understand more aspects about this type of cicatricial alopecia. Several treatments have been used in frontal fibrosing alopecia, although the 5-alpha reductase inhibitors seem to be the most promising. The aim of this report is to provide a compilation about the published data regarding frontal fibrosing alopecia in a narrative review.

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Section: Are Lpp and Ffa The Same Disease?mentioning

confidence: 99%

Frontal Fibrosing Alopecia: A Review

Porriño‐Bustamante

Fernández‐Pugnaire

Arias‐Santiago

2021

JCM

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“…Usually negative in FFA patients [56], although it can be positive in a considerable number of patients presenting LPP; therefore (also with regard to distinct clinical presentation) it may be accurate to describe FFA as a separate disease process [18,56].…”

Section: Direct Cutaneous Immunofluorescence (Dif)mentioning

confidence: 99%

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

Kępińska¹,

Jałowska²,

Bowszyc‐Dmochowska³

2021

Ann Agric Environ Med.

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Despite a significant increase in reported cases of frontal fibrosing alopecia (FFA) in literature, discussion about the possible role of environmental factors, instruction for diagnosis and guideline for treatment, are limited. The review aims to provide a detailed synthesis of this condition that could be used by clinicians in their practise. Whether single-centre or multicentre, studies of more than 60 cases less than 5 years old were mainly taken into consideration. Results obtained were that FFA affects mainly postmenopausal Caucasian women; the most common comorbidities are hyperlipidaemia, arterial hypertension, osteoporosis, hypothyroidism, depression, alongside dermatological disorders such as atopic dermatitis, rosacea, seborrheic dermatitis and androgenetic alopecia. Autoimmune, genetic, hormonal (e.g. estrogen deficiency, pregnancy, lactation, HRT and raloxifene) and environmental (e.g. daily use of facial sunscreens and less frequent use of hair dyes and shampoo) hypotheses were proposed for pathogenesis, as well as association with various predisposing factors (patient's health-social profile, disease's history and comorbidities). Clinical presentation of FFA can be divided into 3 specific patterns, each with a different prognosis. Diagnosis is usually made clinically with the use of trichoscopy; however, scalp biopsy remains the gold standard. The condition is regarded as a variant of lichen planopilaris (LPP) due to the similarity of the prominent histopathological findings, but the clinical image is distinct and therapeutic options vary. 5α-reductase inhibitors, intralesional steroids, and hydroxychloroquine provide the highest level of evidence for the treatment of FFA. The conclusion is that a better understanding of the disease is crucial for proper disease management.

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“…Non-inflammatory facial papules were observed in 56 patients (29.8%). In 48 patients, they In most cases (71.8%), the characteristic clinical presentation (Figure 1) and the typical trichoscopic findings (Figure 2) The literature search identified a total of 24 papers (all published between 2014 and 2021) with more than 100 included cases ( 2018, respectively [26,[42][43][44][45][46][47]. Nine studies were released in 2019 [19,27,[35][36][37][38][39][40][41] and 5 studies were published in 2020…”

Section: Resultsmentioning

confidence: 99%

Clinical and Dermoscopic Approaches to Diagnosis of Frontal Fibrosing Alopecia: Results From a Multicenter Study of the International Dermoscopy Society

Starace¹,

Orlando²,

Iorizzo³

et al. 2022

Dermatol Pract Concept

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Introduction: Frontal fibrosing alopecia (FFA) is a form of primary lymphocytic scarring alopecia characterized by a progressive recession of the fronto-temporal hairline. Although the clinical presentation of FFA is very typical, biopsy for histopathological examination is still recommended to confirm the diagnosis. Currently, a growing number of skin and mucosal inflammatory diseases are diagnosed with modern noninvasive techniques such as dermoscopy without the necessity of a biopsy. Objectives: The International Dermoscopy Society (IDS) aimed to test the ability of its members to diagnose classic FFA through clinical and dermoscopic parameters and to compare acquired data to the largest cohort studies published since 1994. Methods: This is an observational, cross-sectional study describing patient demographics, clinical presentation and diagnostic tools used in a sample of FFA patients collected by IDS members. A literature search was then performed using Pubmed to review studies reporting more than 100 cases. Results: IDS members submitted 188 cases demonstrating a predominant female population (98.4%). In 71.8% of the cases, the clinical presentation and the trichoscopic findings allowed for the diagnosis. Out of 24 revised studies, 13 showed that clinical and trichoscopic features were decisive for the diagnosis in almost all cases. Conclusions: Demographic and clinical data of our cohort were mostly comparable to previous reported data on FFA. The relevant role of the clinical and trichoscopic features in diagnosing FFA was confirmed by our study and the reviewed literature. Trichoscopy could be considered a worldwide-acknowledged non-invasive technique for the diagnosis of FFA.

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The Use of Direct Immunofluorescence in Frontal Fibrosing Alopecia

Cited by 11 publications

References 9 publications

Frontal Fibrosing Alopecia: A Review

Frontal Fibrosing Alopecia: A Review

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

Clinical and Dermoscopic Approaches to Diagnosis of Frontal Fibrosing Alopecia: Results From a Multicenter Study of the International Dermoscopy Society

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