TLDR The document concludes that doctors should check for frontal fibrosing alopecia in patients with acquired hyperpigmentation and that early treatment is important.
The document discusses a case of a 69-year-old Hispanic postmenopausal woman who presented with acquired hyperpigmentation and cicatricial alopecia, specifically lichen planus pigmentosus (LPP) and frontal fibrosing alopecia (FFA). LPP is characterized by grey to brown macules, particularly in sun-exposed areas, and FFA is a scarring alopecia affecting the frontal hairline and eyebrows, mainly in postmenopausal women. The patient's skin and scalp biopsies were consistent with LPP and FFA, respectively. She was treated with chloroquine, topical tacrolimus, and sunscreen, resulting in mild improvement. The document highlights the importance of examining patients with acquired hyperpigmentation for signs of FFA to initiate early treatment and prevent further alopecia. It also notes that more than 50% of patients with FFA have LPP, and LPP usually precedes FFA by several months to years. There is no established treatment for FFA, but corticosteroids, hydroxychloroquine, and oral finasteride or dutasteride have been reported to be effective. The case emphasizes the need for awareness among physicians of the potential coexistence of LPP and FFA.
6 citations,
January 2015 in “Journal of The European Academy of Dermatology and Venereology” Different hair loss types need accurate diagnosis for proper treatment.
339 citations,
February 2014 in “Journal of The American Academy of Dermatology” Most patients with frontal fibrosing alopecia are postmenopausal women, and treatments like finasteride and dutasteride can improve or stabilize the condition.
22 citations,
April 2013 in “International Journal of Dermatology” Frontal fibrosing alopecia can occur with lichen planus pigmentosus, needing careful diagnosis and treatment.
86 citations,
July 2012 in “British journal of dermatology/British journal of dermatology, Supplement” There may be a connection between Frontal Fibrosing Alopecia and Lichen Planus Pigmentosus, and more research is needed to confirm this.
86 citations,
July 2012 in “British journal of dermatology/British journal of dermatology, Supplement” There may be a connection between Frontal Fibrosing Alopecia and Lichen Planus Pigmentosus, and more research is needed to confirm this.
2 citations,
January 2015 in “Springer eBooks” Early diagnosis and aggressive treatment are crucial for Cicatricial Alopecia, and treatment effectiveness varies among patients.
291 citations,
January 2014 in “The Scientific World Journal” Lichen Planus is a less common condition affecting skin and mucous membranes, with various types and associated risk factors, challenging to diagnose, significantly impacts life quality, and may have a risk of cancerous changes in oral lesions.
61 citations,
January 2019 in “American Journal of Clinical Dermatology” The cause of Frontal Fibrosing Alopecia is unclear, diagnosis involves clinical evaluation and various treatments exist, but their effectiveness is uncertain.
13 citations,
August 2020 in “Mayo Clinic proceedings” Women with lichen planopilaris often have thyroid disease, depression, anxiety, and may respond to treatment with slowed disease progression.
