Unusual patterns of presentation of frontal fibrosing alopecia: A clinical and trichoscopic analysis of 98 patients

Rossi, Alfredo; Grassi, Sara; Fortuna, Maria Caterina; Garelli, Valentina; Pranteda, Guglielmo; Caro, Gemma; Carlesimo, Marta

doi:10.1016/j.jaad.2017.02.012

Cited by 22 publications

(26 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since the original reports, evidence has accumulated that considerable clinical overlap exists between FFA and FAPD, or progression between these conditions, suggesting that FAPD may involve the frontal hairline [1, 3, 4, 12]. A pure form of FFA does not present hair miniaturization associated with a lichenoid perifollicular infiltrate and concentric fibrosis in the same scalp biopsy, but the possibility of the existence of the two entities in the same patient must be considered [2, 4, 14]. …”

Section: Discussionmentioning

confidence: 99%

Fibrosing Alopecia in a Pattern Distribution (FAPD) in 16 African-Descent and Hispanic Female Patients: A Challenging Diagnosis

Teixeira

Dias

Trüeb³

et al. 2019

Skin Appendage Disord

View full text Add to dashboard Cite

Background: Fibrosing alopecia in a pattern distribution (FAPD) has only been described in Caucasian patients, and it is not clear whether it can develop in dark-skin ethnicities. Materials and Methods: Sixteen Brazilian female patients, 12 of African descent and 4 Hispanic, with progressive scarring alopecia in a pattern distribution were analyzed. Results: Dermatoscopic features showed perifollicular erythema and scaling (14/16), hair fiber diameter diversity (16/16), loss of follicular ostia (16/16), and follicular keratosis (3/16). Late stages showed a honeycomb pigmented network (12/16), a hyperpigmented perifollicular halo (12/16), and small white patches (12/16). Histopathological features showed lichenoid perifollicular infiltrate (14/16), follicular miniaturization (16/16), concentric fibrosis (16/16), perifollicular lymphocytic infiltrate (16/16), and vellus hair involvement (10/16). Premature desquamation of the inner root sheath was found in 11 patients. Conclusions: The concomitant findings of cicatricial pattern hair loss (with or without the recess of the front hair line), hair fiber diversity, perifollicular erythema and scaling, a whitish perifollicular halo, and histological findings of androgenetic alopecia, with vacuolar interface alteration of the upper portion of the follicular epithelium, are the main key features to suggest the diagnosis of FAPD. FAPD is a possible diagnosis in patients of color with cicatricial pattern hair loss. Clinical, dermatoscopic, and histopathological examination allow a proper final differential diagnosis.

show abstract

Section: Discussionmentioning

confidence: 99%

Fibrosing Alopecia in a Pattern Distribution (FAPD) in 16 African-Descent and Hispanic Female Patients: A Challenging Diagnosis

Teixeira

Dias

Trüeb³

et al. 2019

Skin Appendage Disord

View full text Add to dashboard Cite

show abstract

“…Die bisher publizierten Häufigkeiten zum Befall der Stirn‐Haar‐Grenze und der Augenbrauen konnten in Zuge unserer Zusammenfassung weitgehend reproduziert werden (Tabelle ). In der aktuellen Literatur häufen sich die Hinweise, dass es neben der klassischen Manifestation an der Stirn‐Haar‐Grenze auch atypische Verteilungsmuster an der behaarten Kopfhaut existieren . Zuweilen beschränkt sich das Auftreten auch ausschließlich auf die Augenbrauen .…”

Section: Diskussionunclassified

Frontal fibrosierende Alopezie – Review aktueller Fallbeispiele und Fallserien in PubMed

Valesky

Maier

Kippenberger

et al. 2018

J Deutsche Derma Gesell

View full text Add to dashboard Cite

Zusammenfassung Hintergrund In der 1994 erschienen Erstpublikation zur frontal fibrosierenden Alopezie (FFA) fasste Steven Kossard sechs Patientinnen, die sich allesamt in der Postmenopause befanden, zusammen. Bei der FFA handelt es sich um eine vernarbende Alopezie, die durch die klinischen Kriterien der frontotemporalen Haarlinienregression und den Verlust der Augenbrauen gekennzeichnet ist. In letzten Jahren wurden zunehmend Fallberichte zur Manifestation in der Prämenopause und bei männlichen Patienten publiziert. Ziel der Arbeit Zusammenfassung und Analyse der verfügbaren Literatur in Pubmed zur FFA bezüglich der Epidemiologie, der Begleiterkrankungen, der Krankheitspräsentation, Diagnostik und Therapie. Material und Methoden Die Datenbank Pubmed wurde nach Fallberichten und Fallserien zur FFA durchsucht. Insgesamt wurden 68 Artikel mit insgesamt 932 Patientenfällen eingeschlossen, analysiert und die patientengebundenen Daten ausgewertet. Neben den epidemiologischen Häufigkeiten wie Alter, Geschlecht oder Ethnie wurden zusätzliche Aspekte zu Prädilektionsstellen, assoziierten Hautveränderungen, Begleiterkrankungen, Medikationen und Therapieansprechen sowie die diagnostische Relevanz von Autoantikörpern erfasst. Ergebnisse Teilweise konnten die in Fallserien und Einzelfallberichten publizierten Erkenntnisse bestätigt und besser differenziert werden, wohingegen einzelne Annahmen nicht reproduziert werden konnten. Von besonderer Relevanz ist die in unserer Analyse ermittelte hohe Koinzidenz der FFA mit Schilddrüsenerkrankungen. Schlussfolgerungen Die vorliegende Arbeit präsentiert, die bislang umfangreichste Zusammenfassung der in der Literatur zur FFA publizierten Patientenfälle.

show abstract

“…For such, I read with great interest the paper by Rossi et al reporting 3 unusual clinical patterns of FFA. 2 One of them was previously described by our group, the peculiar sparing of the hairline present in some patients with FFA, which we named the pseudo ''fringe sign''. 3 Interestingly, in 7 of the 16 cases originally reported, sparing of the hairline was more pronounced in the temporal area, as in the cases described by Rossi et al 2 The pseudo ''fringe sign'' pattern of presentation affected 6.2% of subjects in a large series of 242 patients with FFA that was recently published.…”

mentioning

confidence: 95%

“…2 One of them was previously described by our group, the peculiar sparing of the hairline present in some patients with FFA, which we named the pseudo ''fringe sign''. 3 Interestingly, in 7 of the 16 cases originally reported, sparing of the hairline was more pronounced in the temporal area, as in the cases described by Rossi et al 2 The pseudo ''fringe sign'' pattern of presentation affected 6.2% of subjects in a large series of 242 patients with FFA that was recently published. 4 Importantly, this pattern of presentation had the best prognosis in the individuals studied, who presented with less hairline recession and eyebrow involvement.…”

mentioning

confidence: 95%

Acknowledging the pseudo “fringe sign” in frontal fibrosing alopecia has diagnostic and prognostic implications

Pirmez¹,

Vañó‐Galván²

2018

Journal of the American Academy of Dermatology

View full text Add to dashboard Cite

Unusual patterns of presentation of frontal fibrosing alopecia: A clinical and trichoscopic analysis of 98 patients

Cited by 22 publications

References 7 publications

Fibrosing Alopecia in a Pattern Distribution (FAPD) in 16 African-Descent and Hispanic Female Patients: A Challenging Diagnosis

Fibrosing Alopecia in a Pattern Distribution (FAPD) in 16 African-Descent and Hispanic Female Patients: A Challenging Diagnosis

Frontal fibrosierende Alopezie – Review aktueller Fallbeispiele und Fallserien in PubMed

Acknowledging the pseudo “fringe sign” in frontal fibrosing alopecia has diagnostic and prognostic implications

Contact Info

Product

Resources

About