Frontal fibrosing alopecia and extrafacial lichen planus pigmentosum in a caucasian woman

Franco-Muñóz, Monserrat; Lozano-Masdemont, Belén; Ramos-Rodríguez, Claudia

doi:10.1590/abd1806-4841.20176638

Cited by 6 publications

(9 citation statements)

References 8 publications

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“…However, the majority of patients developed LPP prior to FFA. [38][39][40][41] The most common clinical presentation of facial LPP is diffuse type, followed by reticulated and multiple pigmented macules. 37 In our study, facial hyperpigmentation and facial lentiginous macules were observed in more than half of our patients, most of them had characteristics of LPP as confirmed by trichoscopy of speckled blue-gray dots in dotted patterns, dots in circles or pseudonetwork patterns and loss of facial vellus hairs.…”

Section: Discussionmentioning

confidence: 99%

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Clinical characteristics, trichoscopy, histopathology and treatment outcomes of frontal fibrosing alopecia in an Asian population: A retro‐prospective cohort study

Panchaprateep

Ruxrungtham

Chancheewa

et al. 2020

The Journal of Dermatology

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Frontal fibrosing alopecia (FFA) is a distinctive lymphocytic scarring alopecia with rapid increase in prevalence. Most FFA series are retrospectively reported from Caucasians with only few from Asians. The objective of this study was to characterize the clinical, trichoscopic and histopathological findings as well as treatment outcomes. This was a retro‐prospective cohort study of patients diagnosed with FFA from 1 January 2010 to 1 November 2019. All patients were asked to present for re‐examination. Clinical, trichoscopic, histopathological and laboratory data were recorded. A questionnaire was used to investigate hair care, hairstyle and facial skin care compared with age‐matched normal controls. Multivariate analysis was performed in order to clarify factors associated with severity. All 58 FFA patients were female, of whom 27.6% were premenopausal, 37.7% had a history of surgical menopause, 13.8% had thyroid diseases, 69% had eyebrow loss and 32.8% facial papules. On physical examination, 10.3% showed linear pattern, 46.6% diffuse pattern and 43.1% pseudo‐fringe sign. Concomitant lichen planopilaris was found in 25.9%, lichen planus pigmentosus in 24.1% and female pattern hair loss in 48.3%. The most common trichoscopic characteristics in the frontal hairline were lack of follicular ostia (91.4%), perifollicular scales (79.3%) and perifollicular erythema (63.8%). Up to 90% of patients reported FFA as improved or stable after receiving antiandrogen (finasteride or dutasteride) or antimalarial with topical treatment. Multivariate analyses revealed that facial lentiginous macules and trichoscopic perifollicular erythema at the frontal area were FFA severity‐associated factors. “Front puff” Thai hairstyle was associated with FFA, while sunscreens and other cosmetic products were not. In conclusion, diffuse and pseudo‐fringe sign pattern are common in Asian FFA. The most common autoimmune systemic comorbidity is thyroid disease, while common concomitant dermatological diseases are female pattern hair loss, lichen planopilaris and lichen planus pigmentosus. Antiandrogens or antimalarial plus topical treatment are the most useful therapy.

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Section: Discussionmentioning

confidence: 99%

“…The onset of LPP can occur before, concurrent with or after scalp hair loss. However, the majority of patients developed LPP prior to FFA 38–41 . The most common clinical presentation of facial LPP is diffuse type, followed by reticulated and multiple pigmented macules 37 .…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics, trichoscopy, histopathology and treatment outcomes of frontal fibrosing alopecia in an Asian population: A retro‐prospective cohort study

Panchaprateep

Ruxrungtham

Chancheewa

et al. 2020

The Journal of Dermatology

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“…Their association was first reported by Dlova [31] in 24 Afro-Americans (23 females, 1 male). Later, about 100 cases have been reported worldwide [30,[32][33][34][35][36][37][38][39][40][41][42][43]. Epidemiologic data of the association are conflicting, due to the lack of large case series.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, in some studies, FFA precedes the onset of LPPigm, in others LPPigm proceeds to FFA [31, 37, 39, 42]. Interestingly, the association between FFA and LPPigm is rare in Caucasian women with 9 skin phototype ≤III reported cases [32, 35, 39, 40].…”

Section: Discussionmentioning

confidence: 99%

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

Verzì

Lacarrubba

Dall’Oglio

et al. 2020

Skin Appendage Disord

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• 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.

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“…Most patients with coexistence of FFA and LPPigm, found in the literature, were cases with facial involvement preceding FFA [31]. In the opinion of some authors, LPPigm and follicular red dots may not just be limited to facial skin [32][33][34]. An increased incidence of LPP (5.7-16.5%), cutaneous or oral mucosal lichen planus (5.2%) as well as lichen planus-type nail involvement or co-existence of FFA and Graham-Little-Piccardi Syndrome has also been reported [35,36].…”

Section: Clinical Manifestations Of Classical Ffamentioning

confidence: 99%

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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Frontal fibrosing alopecia and extrafacial lichen planus pigmentosum in a caucasian woman

Cited by 6 publications

References 8 publications

Clinical characteristics, trichoscopy, histopathology and treatment outcomes of frontal fibrosing alopecia in an Asian population: A retro‐prospective cohort study

Clinical characteristics, trichoscopy, histopathology and treatment outcomes of frontal fibrosing alopecia in an Asian population: A retro‐prospective cohort study

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

Frontal fibrosing alopecia: a disease that remains enigmatic

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