Association of Frontal Fibrosing Alopecia with Facial Papules and Lichen Planus Pigmentosus in a Caucasian Woman

Abstract

• In the last few years, there has been a dramatic increase in cases of frontal fibrosing alopecia (FFA) reported worldwide. • The association of FFA, facial papules, and lichen pigmentosus has been reported mainly in subjects with phototype ≥IV. Novel Insights • We report the association of FFA, facial papules, and lichen pigmentosus in a phototype III Caucasian woman. • Clinicians should be aware of this association also in subjects with fair skin, as it may be useful for diagnostic and prognostic purposes.

Multiple Clinical Manifestations of Lichenoid Spectrum: A Patient with Frontal Fibrosing Alopecia, Lichen Planus Pigmentosus, and Nail Lichen Planus

“…The coexistence of two diseases is frequently described in women with dark-skin phenotypes (Fitzpatrick IV, V). However, a recent case and case series and our patient demonstrate that light-skin phenotype may also be affected (Fitzpatrick II, III) [6, 8]. The etiology of both diseases is not clear.…”

“…The association of FFA and LPP was first reported in 2013 by Dlova et al [5]. Since then several cases/case series have been reported in recent years [6-8]. The coexistence of two diseases is frequently described in women with dark-skin phenotypes (Fitzpatrick IV, V).…”

Coexistence of Lichen Planus Pigmentosus and Classic Lichen Planopilaris: A Case Report and Literature Review

“…However, few articles reported this association in Caucasians or lighter skin phototypes (II and III). [13,15,16]. Most patients with this association were postmenopausal women [11,7,13].…”

“…It was first described in 2013 by Dlova et al in 24 patients in South Africa [10]. Since then, many articles have identified this association in English literature [7,[11][12][13][14][15][16][17][18]. The largest study was a multi-centric retrospective study of 104 patients.…”

“…However, in the case series by Dlova et al, an earlier age of onset was noticed (64% were premenopausal), which was attributed to the marked traction exerted by African women on their hairstyle, which ended up damaging the follicle early. The onset of hair loss and pigmentation was variable between studies; LPPigm can present before [10,11,13,14,16] or after FFA [12,15,17], or they can occur simultaneously [13,18]. Lichen planus pigmentosus preceded the onset of FFA in many cases [10,11,13,14].…”