Frontal Fibrosing Alopecia: Update and Review of Challenges and Successes

To, Derek; Beecker, Jennifer

doi:10.1177/1203475417736279

Cited by 24 publications

(28 citation statements)

References 49 publications

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“…However, complete eyebrow loss appeared to be more prevalent among female patients. This eyebrow involvement in FFA's hair loss pattern could play a significant role in the early detection of the disease, as in many cases, thinning or loss of eyebrows reportedly precedes the recession of the frontotemporal hairline …”

Section: Discussionmentioning

confidence: 97%

Frontal fibrosing alopecia: demographic and clinical characteristics of 490 cases

Kanti

Constantinou

Reygagne

et al. 2019

Acad Dermatol Venereol

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Background Frontal fibrosing alopecia (FFA) is a cicatricial alopecia mostly affecting the frontotemporal hairline. Its aetiology and associated factors remain unclear.Objective and methods An observational, cross-sectional and descriptive study was conducted in France and Germany to identify demographic and health characteristics associated with the severity of FFA. ResultsOf 490 included patients, 95% were female, of which 84% were postmenopausal. Age at onset of FFA symptoms ranged between 15 and 89 years, but diagnosis was frequently delayed up to 24 years. Lichen Planopilaris Activity Index scores were low (median 1.8, IQR 1.0 to 3.5). Thyroid function disorders were reported in 13% of men and 35% of women. Abnormal blood lipid levels were found in 42% of tested men and 47% of women. In the bivariate analyses, LPPAI scores were negatively correlated with abnormal testosterone (r s = À0.775) and oestrogen values (r s = À0.664), regular use of face cleaning products (r s = À0.465), hair colourants (r s = À0.679) and hairspray (r s = À0.500).Conclusions The most common comorbidity was thyroid disease, with proportions higher than in the European population, possibly reflecting a role of thyroid hormones in FFA pathogenesis. The association of abnormal testosterone and oestrogen values with lesser disease activity needs to be explored in further studies. Our correlation analyses do not support a role of leave-on cosmetic products in the pathophysiology of FFA.

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Section: Discussionmentioning

confidence: 97%

Frontal fibrosing alopecia: demographic and clinical characteristics of 490 cases

Kanti

Constantinou

Reygagne

et al. 2019

Acad Dermatol Venereol

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“…Frontal fibrosing alopecia (FFA) is a progressive scarring alopecia that occurs on the frontotemporal area [1]. Band-like scarring alopecia localized on the frontal, temporal, and parietal hairline and a partial or complete loss of eyebrows are often observed in FFA [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…FFA is rarely seen in men with an incidence of 3-5% among all patients. [1,5]. The ethiopathogenesis of FFA is still unclear.…”

Section: Introductionmentioning

confidence: 99%

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Review of clinical and demographic features of frontal fibrosing alopecia

Atış¹,

Ferhatoğlu²

2018

Journal of Surgery and Medicine

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This is an open access article distributed under the terms of the CreativeCommons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND 4.0) where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. Abstract Aim: Frontal fibrosing alopecia (FFA) is a progressive scarring alopecia that occurs on the frontotemporal area. The ethiopathogenesis of FFA is still unclear. Genetic predisposition, hormonal and environmental factors, and the use of personal care products have been put forward as etiological factors. Our aim was to evaluate the clinical and demographical features of FFA patients retrospectively during a two-year follow-up period. Methods: Patients who admitted to our dermatology out-patient clinic between January 2016 and January 2018 were included in the study. Diagnosis was made histologically or based on the typical clinical presentation (ear to ear hair loss). Age at first presentation and onset of FFA, relevant medical comorbidities, family history, menopause status, clinical features, and medical therapies administered were recorded. Results: All the patients were female and post-menopausal. Seven patients (87.75%) had hair loss on the eyebrows. Lonely hairs were observed in five patients (62.5%). Depression of frontal veins was observed in two patients (25%). Perifollicular erythema was observed in three patients (37.5%), and perifollicular scale was observed in four patients (50%). One of the patients (12.25%) exhibited a doll hair line. Two patients (25%) had early menopause history. The mean age of onset for graying hair was 30.87±11.39. Three patients (37.5%) had a history of premature hair graying. All the patients dyed their hair, and the mean age of hair dyeing was 31.5±10.50. Conclusion: Perifollicular erythema and perifollicular scaling are important trichoscopic features of FFA. Environmental factors, autoimmune processes, and hormonal factors play a role in the development of FFA in genetically predisposed individuals. Premature hair graying and/or use of hair dyes (especially at early ages) can be a triggering or etiopathogenic factor for FFA. Öz Amaç: Frontal fibrozan alopesi (FFA) frontotemporal bölgede lokalize, ilerleyici bir sikatrisyel alopesidir. Etiyopatogenezi halen tam olarak bilinmemektedir. Genetik yatkınlık, hormonal ve çevresel faktörler, kişisel bakım ürünleri etyolojide suçlanmaktadır. Amacımız son 2 yıl içerisinde gözlenen FFA'lı olguların klinik ve demografik özelliklerinin incelenmesidir. Yöntemler: Ocak 2016-Ocak 2018 tarihleri arasında dermatoloji polikliniğine FFA nedeniyle başvuran hastalar çalışmaya dahil edildi. Tanı histopatolojik olarak ya da tipik klinik bulgulara dayanılarak konuldu. Hastaların başvuru esnasındaki yaşı, hastalık başlangıç yaşı, ilişkili olabilecek tıbbi hastalıkları, aile öyküleri, menapoz durumları, klinik bulguları ve aldıkları tedaviler kaydedildi. Bulgular: Hastaların hepsi kadın ve postmenapozal idi....

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“…Frontal fibrosing alopecia, as described by Kossard, is a scarring alopecia that occurs most often in postmenopausal women [26]. It is clinically characterized by a progressive recession of the frontal and temporal hair lines with follicular hyperkeratosis, perifollicular erythema, and loss of follicular ostia [2].…”

Section: Clinical Featuresmentioning

confidence: 99%

Cicatricial Alopecia

Su¹,

Yang²,

Dou³

et al. 2018

Alopecia

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Cicatricial alopecia represents a group of disorders sharing a final pathway of destruction followed by replacement with fibrous tissue of the hair follicle unit. Cicatricial alopecia is classified into two categories, namely primary cicatricial alopecia, in which the hair follicle is the sole target of a progressive inflammatory process in a group of diverse skin or systemic diseases, and secondary cicatricial alopecia, referring to the hair follicle destruction as a result of a nonspecific disruption of the dermis. Permanent hair loss may also occur in the late phases of some nonscarring alopecias that are called "biphasic alopecias." Based on the pathological characteristics, the lesions of primary cicatricial alopecia are divided into lymphocyte-predominant subgroup, neutrophil-predominant subgroup, or mixed subgroup. In principle, the primary goal of the treatment aims to attenuate the progression of the inflammatory and the scarring processes at the earliest phase of the disease. In clinical practice, the lymphocyte-predominant lesions are treated with immunosuppressive agents, whereas the neutrophil-predominant lesions are treated with antimicrobials or dapsone. As the efficacy of medication treatment against the cicatricial alopecia varies significantly, autologous hair transplantation is recommended to patients who have a relatively stable primary or a secondary cicatricial alopecia.

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Frontal Fibrosing Alopecia: Update and Review of Challenges and Successes

Abstract: The aetiology and clinical course of FFA remain to be established. Unfortunately, despite the numerous treatment options available, no one therapeutic regimen has proven effective in stopping recession of the hairline and inducing hair growth.

Cited by 24 publications

References 49 publications

Frontal fibrosing alopecia: demographic and clinical characteristics of 490 cases

Frontal fibrosing alopecia: demographic and clinical characteristics of 490 cases

Review of clinical and demographic features of frontal fibrosing alopecia

Cicatricial Alopecia

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