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

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.