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Frontal fibrosing alopecia

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The text is the summary of recent articles on Frontal fibrosing alopecia at 75 thresold from National Library of Medicine (NLM). This information is subject to NCBI's Disclaimer and Copyright notice.


Common hair diseases in the elderly include androgenetic alopecia, senile alopecia, frontal fibrosing Alopecia, and erosive pustular dermatosis of the scalp [1]. In this retrospective cohort study, 236 trichoscopic images of the frontotemporal and sideburn area obtained via dry trichoscopy from patients with biopsy-proven FFA were examined by two independent researchers to determine the trichoscopic features of FFA in the sideburns [2]. Peripilar casts and peripilar erythema were rare in the sideburns compared to the frontotemporal area [3]. Clinical and basic science investigations are now focusing on three forms of human PCA: lichen planopilaris (LPP), frontal fibrosing alopecia (FFA) and central centrifugal cicatricial alopecia (CCCA) [4]. Additional treatments were topical Tacrolimus, Systemic Retinoids, and hydroxychloroquine [5].

Lichen planus pigmentosus is an uncommon variant of lichen planus frequently associated with frontal fibrosing alopecia in darker phototipes [6]. The condition has been associated with further histopathologic and/or clinical evidence of lichen planopilaris [7]. Since its emergence with the original report of Kossard in 1994, frontal fibrosing alopecia has been recognized to be associated with a Number of comorbidities, including lupus erythematosus [8]. So far, respective case reports and case series have given account of frontal fibrosing alopecia with the histopathologic features of lichen planopilaris associated or overlapping with lupus erythematosus [9]. LPP can present concomitantly with other variants of LP such as frontal fibrosing alopecia, as well as endocrinopathies, and autoimmune diseases [10].

We included all retrospective and prospective studies reported in English [11]. It was based on a retrospective analysis of 54 female patients with FFA treated with: Oral Isotretinoin at the daily dose of 20 mg (29/54) or Acitretin at the daily dose of 20 mg (11/54) or with Oral finasteride 5 mg/daily (14/54) [12]. The primary treatment goal was defined as no further progression of disease after 12 months of treatment, while the secondary treatment goal was defined as no further progression of disease following the discontinuation of Systemic Retinoids [13]. Since the original reports, evidence has accumulated that there exists considerable clinical overlap among FFA, FAPD, and lichen planopilaris, with coexistence of features of the three conditions within the same Individual [14]. Moreover, familial cases of FFA have been reported, pointing to a possible genetic background to the condition [15].

The follicular pattern was the most common, and the predominant Inflammatory Infiltrate was Lymphocytic [16]. lichen planopilaris and frontal fibrosing alopecia were the main diagnoses [17]. Vascular flow in the alopecic band is decreased compared to Inflammatory Scalp and controls in the superficial levels, but increased at deeper levels as compared to controls [18]. It is difficult to establish if the increased flow in the Inflammatory stage is due to neovascularization as seen in other ischaemic diseases or is the result of the inflammatory response [19]. Of the 103 patients, 41 Women and 34 men were diagnosed with classic LPP (CLPP) and 26 Women and 1 man with frontal fibrosing alopecia (FFA), while Graham-Little-Piccardi-Lassueur syndrome (GLPLS) was identified in 1 man [20].

References: 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ,

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