Frontal Fibrosing Alopecia: A Case Series of 65 Patients Seen in a Single Italian Centre

    November 2018 in “ Journal of the European Academy of Dermatology and Venereology ”
    Michela Starace, Nicolò Brandi, Aurora Alessandrini, Francesca Bruni, Bianca Maria Piraccini
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    TLDR The study concluded that severity of Frontal fibrosing alopecia is not linked to how long someone has it, can start before menopause, and eyebrow loss may be an early sign.
    The study analyzed 65 Caucasian female patients with Frontal fibrosing alopecia (FFA) and found an increasing number of diagnoses per year, with 21% beginning before menopause. Common symptoms included frontal hairline recession, eyebrow alopecia in 86.1% of patients, and scalp itching in 90%, which indicated disease progression. Trichoscopy was crucial for diagnosis, revealing features like follicular hyperkeratosis and perifollicular erythema. A skin biopsy confirmed the diagnosis in 10 patients. Co-occurrence with other autoimmune diseases was noted in 50% of patients, and 35.4% had an atopic background. The study also found a high frequency of sunscreen use and antidepressant or anxiolytic medication among patients. Despite treatment, which typically included steroids and maintenance therapy with 5 alpha-reductase inhibitors or hydroxychloroquine, 25% of patients saw progression. The study concluded that FFA severity is not related to its duration, may begin before menopause, and eyebrow loss could be an early indicator of the condition.
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