Frontal fibrosing alopecia: a survey in 16 patients

Abstract

Cases of Kossard's type scarring alopecia affecting premenopausal women made us consider that this condition is not exclusive of postmenopausal women. Differential diagnosis should take into account conditions like female androgenetic alopecia, fibrosing alopecia in a pattern distribution, alopecia areata, and chronic lupus erythematosus. Except for the pattern of alopecia, lichen planopilaris and frontal fibrosing alopecia are indistinguishable, thus the latter is included as a variant of lichen planopilaris. Although the disease tends to spontaneous stabilization, intralesional and topical corticosteroids, and anti-androgens may stop the progression of the disease and improve the female androgenetic alopecia that usually is associated to FFA.

Examination of Clinical and Demographic Characteristics of 14 Cases with Frontal Fibrosing Alopecia

“…However, this measurement was not taken in our cases. 96% of the published cases were reported to have paleness in alopecic skin, destruction of follicular orifices, and skin atrophy without clinical induration and sclerosis (1,5,6,20). All our cases had cicatricial alopecia.…”

“…Eyebrow loss and thinning is frequent, and helps to make diagnosis. Thinning or total loss of the eyebrows was reported in 50-95% of the FFA cases (6,12,13,15). Vona et al stated that eyebrow loss is present in moderate-severe cases (14).…”

“…As with all our cases, symmetrical and bilateral traction on the frontal and temporal hairline of the patients is explicit. This traction increases even more over time (2,6,7). Traction on the hairline may vary, progresses slowly and spontaneously stop years after onset (6,7,20).…”

“…This traction increases even more over time (2,6,7). Traction on the hairline may vary, progresses slowly and spontaneously stop years after onset (6,7,20). The severity of the disease may also be identified by measuring glabellar-frontal distance which is normally 5.9 cm on average (7).…”

“…Despite its well-known clinical presentation, clinical studies regarding its treatment are not adequate (2,6). Case reports and series were reported in local and foreign literature (10)(11)(12)(13)(14)(15)(16)(17)(18)(19).…”