Frontal Fibrosing Alopecia Presenting as Androgenetic Alopecia in an African American Woman

Abstract

Frontal fibrosing alopecia (FFA) is a primary lymphocytic cicatricial alopecia that is currently regarded as a variant of lichen planopilaris. FFA has historically been considered rare in black patients, in whom traction alopecia, central centrifugal cicatricial alopecia, and androgenetic alopecia are frequently assumed to be more common. We describe a case of FFA in a black woman that both clinically resembled androgenetic alopecia and lacked many of the physical exam and dermoscopic findings associated with FFA. In doing so, we highlight the need for physicians to have a high index of suspicion for FFA in any black patient who presents with frontotemporal alopecia.

Considerations and recommendations on camouflage in alopecia in Black women

“…22 The exact prevalence of FFA in Black populations has not been elucidated; however, studies have shown that FFA may be underdiagnosed or misdiagnosed in Black individuals given its unique presentation. 23,24 The diagnosis of alopecia can be devastating and have profound impacts on quality of life. 25,26 For many individuals, hair is a central component of identity and self-expression, the loss of which can have significant psychosocial effects.…”

“… 22 The exact prevalence of FFA in Black populations has not been elucidated; however, studies have shown that FFA may be underdiagnosed or misdiagnosed in Black individuals given its unique presentation. 23 , 24 …”