Frontal fibrosing alopecia is the frontotemporal hairline recession and eyebrow loss in postmenopausal women that is associated with perifollicular erythema, especially along the hairline.[2][3]: 648 It is considered to be a clinical variant of lichen planopilaris.[4]
There is loss of both terminal and vellus hairs that occurs in a bandlike pattern on the frontotemporal scalp.[5] It is a scarring alopecia that has been associated with facial papules, glabellar red dots, a loss of eyebrows, and prominent venous vasculature in the forehead.[6][7][8][9] Facial hyperpigmentation may occur in dark-skinned patients if association with lichen planus pigmentosus is present.[10]
Associationsedit
Frontal fibrosing alopecia has been most often reported in post-menopausal women with higher levels of affluence and a negative smoking history. Autoimmune disease is found in 30% of patients.[6][11]
Pathogenesisedit
Although the pathogenesis of frontal fibrosing alopecia is poorly understood, autoimmune reaction and hormonal factors may play a role.[6]
Diagnosticedit
Perifollicular erythema and scarring white patches are seen on dermoscopy. On scalp biopsy, lymphocytic and granulomatous perifolliculitis with eccentric atrophy of follicular epithelia and perifollicular fibrosis are visualized.[12]
Differential diagnosisedit
Important diagnoses to consider include female pattern hair loss (FPHL), chronic telogen effluvium (CTE), and alopecia areata (AA). FPHL is a non-scarring progressive miniaturization of the hair follicle with one of three different characteristic patterns. CTE is an idiopathic disease causing increased hair shedding and bi-temporal recession, usually in middle aged women. AA is an autoimmune attack of hair follicles that usually causes hair to fall out in small round patches.[13]
Treatmentedit
Improvement or stabilization of the condition has been reported with topical and intralesional corticosteroids, antibiotics, hydroxychloroquine, topical and oral immunomodulators, tacrolimus, and most recently, 5α-reductase inhibitors. In one study, the use of antiandrogens (finasteride or dutasteride) was associated with improvement in 47% and stabilization in 53% of patients [14] Recently, successful treatment of facial papules in patients with frontal fibrosing alopecia was described with oral isotretinoin.[15]
^RESERVED, INSERM US14-- ALL RIGHTS. "Orphanet: Frontal fibrosing alopecia". www.orpha.net. Retrieved 26 April 2019.{{cite web}}: CS1 maint: numeric names: authors list (link)
^Wang, Monga I, Sallee BN, Chen JC, Abdelaziz AR, Perez-Lorenzo R, Bordone LA, Christiano AM (Jul 2022). "Primary cicatricial alopecias are characterized by dysregulation of shared gene expression pathways". PNAS Nexus. 1 (3): pgac111. doi:10.1093/pnasnexus/pgac111. PMC9308563. PMID 35899069.
^Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN0-07-138076-0.
^Lacarrubba, F; Micali, G; Tosti, A (Mar 18, 2013). "Absence Of Vellus Hair In The Hairline: A Videodermatoscopic Feature Of Frontal Fibrosing Alopecia". The British Journal of Dermatology. 169 (2): 473–4. doi:10.1111/bjd.12316. PMID 23496000. S2CID 9044042.
^Kossard S, Lee MS, Wilkinson B. Postmenopausal alopecia: a frontal variant of lichen planopilaris. J Am Acad Dermatol. 1997;36(1):59.
^ abcMacdonald A, Clark C, Holmes S. Frontal fibrosing alopecia: a review of 60 cases. J Am Acad Dermatol. 2012;67(5):955-61.
^Banka N, Mubki T, Bunagan MJ, Mcelwee K, Shapiro J. Frontal fibrosing alopecia: a retrospective clinical review of 62 patients with treatment outcome and long-term follow-up. Int J Dermatol. 2014;53(11):1324-30.
^Pirmez R, Donati A, Valente NS, Sodré CT, Tosti A. Glabellar red dots in frontal fibrosing alopecia: a further clinical sign of vellus follicle involvement. Br J Dermatol. 2014;170(3):745-6.
^Vañó-galván S, Rodrigues-barata AR, Urech M, et al. Depression of the frontal veins: A new clinical sign of frontal fibrosing alopecia. J Am Acad Dermatol. 2015;72(6):1087-8.
^Pirmez R, Duque-Estrada B, Donati A, Campos-do-Carmo G, Valente NS, Romiti R, Sodré CT, Tosti A. Clinical and dermoscopic features of lichen planus pigmentosus in 37 patients with frontal fibrosing alopecia. Br J Dermatol. 2016 May 28. doi: 10.1111/bjd.14722.
^Kossard S. Postmenopausal frontal fibrosing alopecia: scarring alopecia in a pattern distribution. Arch Dermatol 1994;130:770-4.
^Dhurat R, Saraogi P. Hair evaluation methods: merits and demerits. Int J Trichology. 2009;1(2):108-19.
^Herskovitz I, Tosti A. Female pattern hair loss. Int J Endocrinol Metab. 2013;11(4):e9860.
^Vañó-galván S, Molina-ruiz AM, Serrano-falcón C, et al. Frontal fibrosing alopecia: a multicenter review of 355 patients. J Am Acad Dermatol. 2014;70(4):670-8.
^Pirmez R, Duque-Estrada B, Barreto T, Quintella DC, Cuzzi T. Successful Treatment of Facial Papules in Frontal Fibrosing Alopecia with Oral Isotretinoin. Skin Appendage Disord 2017;3:111-113. doi=10.1159/000464334
External linksedit
January 01, 1970
frontal, fibrosing, alopecia, this, article, lead, section, technical, most, readers, understand, please, help, improve, make, understandable, experts, without, removing, technical, details, july, 2022, learn, when, remove, this, message, frontotemporal, hairl. This article s lead section may be too technical for most readers to understand Please help improve it to make it understandable to non experts without removing the technical details July 2022 Learn how and when to remove this message Frontal fibrosing alopecia is the frontotemporal hairline recession and eyebrow loss in postmenopausal women that is associated with perifollicular erythema especially along the hairline 2 3 648 It is considered to be a clinical variant of lichen planopilaris 4 Frontal fibrosing alopeciaOther namesFFA 1 SpecialtyDermatology Contents 1 Presentation 1 1 Associations 2 Pathogenesis 3 Diagnostic 3 1 Differential diagnosis 4 Treatment 5 See also 6 References 7 External linksPresentation editThere is loss of both terminal and vellus hairs that occurs in a bandlike pattern on the frontotemporal scalp 5 It is a scarring alopecia that has been associated with facial papules glabellar red dots a loss of eyebrows and prominent venous vasculature in the forehead 6 7 8 9 Facial hyperpigmentation may occur in dark skinned patients if association with lichen planus pigmentosus is present 10 Associations edit Frontal fibrosing alopecia has been most often reported in post menopausal women with higher levels of affluence and a negative smoking history Autoimmune disease is found in 30 of patients 6 11 Pathogenesis editAlthough the pathogenesis of frontal fibrosing alopecia is poorly understood autoimmune reaction and hormonal factors may play a role 6 Diagnostic editPerifollicular erythema and scarring white patches are seen on dermoscopy On scalp biopsy lymphocytic and granulomatous perifolliculitis with eccentric atrophy of follicular epithelia and perifollicular fibrosis are visualized 12 Differential diagnosis edit Important diagnoses to consider include female pattern hair loss FPHL chronic telogen effluvium CTE and alopecia areata AA FPHL is a non scarring progressive miniaturization of the hair follicle with one of three different characteristic patterns CTE is an idiopathic disease causing increased hair shedding and bi temporal recession usually in middle aged women AA is an autoimmune attack of hair follicles that usually causes hair to fall out in small round patches 13 Treatment editImprovement or stabilization of the condition has been reported with topical and intralesional corticosteroids antibiotics hydroxychloroquine topical and oral immunomodulators tacrolimus and most recently 5a reductase inhibitors In one study the use of antiandrogens finasteride or dutasteride was associated with improvement in 47 and stabilization in 53 of patients 14 Recently successful treatment of facial papules in patients with frontal fibrosing alopecia was described with oral isotretinoin 15 See also editSkin lesionReferences edit RESERVED INSERM US14 ALL RIGHTS Orphanet Frontal fibrosing alopecia www orpha net Retrieved 26 April 2019 a href Template Cite web html title Template Cite web cite web a CS1 maint numeric names authors list link Wang Monga I Sallee BN Chen JC Abdelaziz AR Perez Lorenzo R Bordone LA Christiano AM Jul 2022 Primary cicatricial alopecias are characterized by dysregulation of shared gene expression pathways PNAS Nexus 1 3 pgac111 doi 10 1093 pnasnexus pgac111 PMC 9308563 PMID 35899069 Freedberg et al 2003 Fitzpatrick s Dermatology in General Medicine 6th ed McGraw Hill ISBN 0 07 138076 0 Lacarrubba F Micali G Tosti A Mar 18 2013 Absence Of Vellus Hair In The Hairline A Videodermatoscopic Feature Of Frontal Fibrosing Alopecia The British Journal of Dermatology 169 2 473 4 doi 10 1111 bjd 12316 PMID 23496000 S2CID 9044042 Kossard S Lee MS Wilkinson B Postmenopausal alopecia a frontal variant of lichen planopilaris J Am Acad Dermatol 1997 36 1 59 a b c Macdonald A Clark C Holmes S Frontal fibrosing alopecia a review of 60 cases J Am Acad Dermatol 2012 67 5 955 61 Banka N Mubki T Bunagan MJ Mcelwee K Shapiro J Frontal fibrosing alopecia a retrospective clinical review of 62 patients with treatment outcome and long term follow up Int J Dermatol 2014 53 11 1324 30 Pirmez R Donati A Valente NS Sodre CT Tosti A Glabellar red dots in frontal fibrosing alopecia a further clinical sign of vellus follicle involvement Br J Dermatol 2014 170 3 745 6 Vano galvan S Rodrigues barata AR Urech M et al Depression of the frontal veins A new clinical sign of frontal fibrosing alopecia J Am Acad Dermatol 2015 72 6 1087 8 Pirmez R Duque Estrada B Donati A Campos do Carmo G Valente NS Romiti R Sodre CT Tosti A Clinical and dermoscopic features of lichen planus pigmentosus in 37 patients with frontal fibrosing alopecia Br J Dermatol 2016 May 28 doi 10 1111 bjd 14722 Kossard S Postmenopausal frontal fibrosing alopecia scarring alopecia in a pattern distribution Arch Dermatol 1994 130 770 4 Dhurat R Saraogi P Hair evaluation methods merits and demerits Int J Trichology 2009 1 2 108 19 Herskovitz I Tosti A Female pattern hair loss Int J Endocrinol Metab 2013 11 4 e9860 Vano galvan S Molina ruiz AM Serrano falcon C et al Frontal fibrosing alopecia a multicenter review of 355 patients J Am Acad Dermatol 2014 70 4 670 8 Pirmez R Duque Estrada B Barreto T Quintella DC Cuzzi T Successful Treatment of Facial Papules in Frontal Fibrosing Alopecia with Oral Isotretinoin Skin Appendage Disord 2017 3 111 113 doi 10 1159 000464334External links edit Retrieved from https en wikipedia org w index php title Frontal fibrosing alopecia amp oldid 1183080986, wikipedia, wiki, book, books, library,
