Clinical and Dermoscopic Approaches to Diagnosis of Frontal Fibrosing Alopecia: Results From a Multicenter Study of the International Dermoscopy Society

    February 2022 in “ Dermatology practical & conceptual ”
    Michela Starace, Gloria Orlando, Matilde Iorizzo, Aurora Alessandrini, Francesca Bruni, Victor Desmond Mandel, Kelati Awatef, Horacio Cabo, Gabriella Fabbrocini, Hanane Baybay, Sven Lanssens, Alejandro Lobato‐Berezo, Fatima Zahra Mernissi, John Paoli, Angela Patrì, Emilia N. Cohen Sabban, Martyna Sławińska, Michał Sobjanek, Oscar Zaar, Giovanni Pellacani, Bianca Maria Piraccini
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    TLDR The study concludes that early diagnosis of Frontal Fibrosing Alopecia is important, as it is often found in postmenopausal women, may be related to Lichen Planopilaris, and eyebrow hair loss is a common sign.
    The study presents a large cohort of patients diagnosed with Frontal Fibrosing Alopecia (FFA), a disease that primarily affects postmenopausal women (88.1%) but can also occur in younger women (11.9%) and men. The average age at onset was 58.6 years. The study found an association between FFA and Lichen Planopilaris (LPP) in 18.6% of cases, supporting the theory that FFA could be a clinical variant of LPP. Androgenetic Alopecia (AGA) was present in 38.8% of patients, suggesting a possible shared pathogenetic mechanism with FFA. The diagnosis of FFA was typically made 4.4 years after the onset of the disease, often at a severe stage, highlighting the need for increased awareness and early diagnosis. Alopecia of the eyebrows was the most common sign of the disease, found in 85.6% of cases. Trichoscopy was a useful tool in diagnosing milder cases and differentiating FFA from other conditions. Inflammatory signs were present in over 60% of patients, and 65.9% reported itching. The study suggests further research into non-invasive imaging techniques for diagnosing FFA.
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