Frontal Fibrosing Alopecia: A New Autoimmune Entity?

January 2019 in “ Medical Hypotheses ”

Juan Esteban García-Robledo, Cristian C. Aragón, Ivana Nieto‐Aristizábal, Sara Vásquez, Claudia Montoya, Gabriel J. Tobón

frontal fibrosing alopecia autoimmune disease lymphocytic infiltrates immunomodulatory drugs hypoandrogenism DHEA scarring hairline regression

TLDR Frontal Fibrosing Alopecia might be an autoimmune disease.

The document from 2019 discusses Frontal Fibrosing Alopecia (FFA), a condition primarily affecting postmenopausal Caucasian women, characterized by hairline regression and scarring. It proposes that FFA may be an autoimmune disease, citing evidence such as lymphocytic infiltrates, association with other autoimmune disorders, and response to immunomodulatory drugs. Out of 921 reported cases, only 29 were male, supporting the hypothesis that hypoandrogenism could be a factor, given FFA's prevalence in postmenopausal women with reduced DHEA serum levels. The document also notes that future research should investigate the autoimmune origin of FFA, with one study including 1083 patients and another involving biopsies from five patients with FFA.

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research Coexistence of Chronic Cutaneous Lupus Erythematosus and Frontal Fibrosing Alopecia

12 citations , March 2018 in “Anais brasileiros de dermatologia/Anais Brasileiros de Dermatologia”

A patient had both chronic cutaneous lupus erythematosus and frontal fibrosing alopecia.

research Frontal Fibrosing Alopecia Among Men: A Clinicopathologic Study of 7 Cases

41 citations , July 2017 in “Journal of The American Academy of Dermatology”

Men with Frontal fibrosing alopecia typically lose hair on the front scalp and sometimes on sideburns and upper lip, with treatments showing varied success.

research Hypopigmentation in Frontal Fibrosing Alopecia

23 citations , May 2017 in “Journal of the American Academy of Dermatology”

FFA patients have fewer melanocytes and thinner skin compared to others.

research Frontal Fibrosing Alopecia in Association with Sjögren's Syndrome: More Than a Simple Coincidence

12 citations , October 2016 in “Anais Brasileiros de Dermatologia”

Frontal Fibrosing Alopecia may be linked to autoimmune diseases like Sjögren's syndrome.

research Frontal Fibrosing Alopecia in Men: Presentation of 12 Cases and Literature Review

26 citations , August 2016 in “Actas Dermo-Sifiliográficas”

Frontal Fibrosing Alopecia in men is often missed and can come with symptoms like facial bumps and hair loss on eyebrows and limbs.

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31 citations , January 2016 in “Skin Appendage Disorders”

Frontal fibrosing alopecia and vitiligo might be linked, not just coincidental.

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20 citations , January 2016 in “Intractable & Rare Diseases Research”

Combination therapy, especially with finasteride, is effective for treating frontal fibrosing alopecia.

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166 citations , April 2012 in “Journal of The American Academy of Dermatology”

Mostly postmenopausal Caucasian women get Frontal Fibrosing Alopecia, which often includes eyebrow loss and has limited treatment success.

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35 citations , August 2009 in “Journal of the American Academy of Dermatology”

Melanocytes might be targeted by the immune system in people with alopecia areata, but more research is needed.

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7 citations , December 2008 in “Expert Review of Dermatology”

The document concludes that various childhood hair and nail disorders exist, some may improve on their own, and advances in genetics and immunology could enhance treatment and counseling.

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54 citations , November 2007 in “Actas Dermo-Sifiliográficas”

Early diagnosis of frontal fibrosing alopecia is crucial to prevent permanent hair loss.

research Frontal Fibrosing Alopecia Versus Lichen Planopilaris: A Clinicopathological Study

126 citations , April 2006 in “International Journal of Dermatology”

The conclusion is that FFA and LPP have similar scalp biopsy features, making them hard to distinguish histologically, and FFA may be a specific kind of scarring hair loss.

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450 citations , January 2005 in “The journal of investigative dermatology/Journal of investigative dermatology”

Hair color is determined by melanin produced and transferred in hair follicles.

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179 citations , December 2004 in “Journal of The American Academy of Dermatology”

Some postmenopausal women with frontal fibrosing alopecia stopped losing hair with finasteride treatment, hinting at a possible hormonal cause.

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254 citations , December 2003 in “Journal of the American Academy of Dermatology”

Accurate diagnosis and aggressive treatment are crucial to prevent permanent hair loss in cicatricial alopecia.

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329 citations , January 1997 in “Journal of the American Academy of Dermatology”

Frontal fibrosing alopecia is a hair loss condition in postmenopausal women, similar to lichen planopilaris, with ineffective treatments.

research Postmenopausal Frontal Fibrosing Alopecia

325 citations , June 1994 in “Archives of Dermatology”

Postmenopausal frontal fibrosing alopecia may be a unique condition linked to postmenopausal changes.