Peculiar Hypertrichosis in a Patient Affected by Frontal Fibrosing Alopecia with Pseudo Fringe Sign

July 2020 in “ Giornale italiano di dermatologia e venereologia ”

Sara Grassi, Marta Carlesimo, Maria Caterina Fortuna, Alfredo Rossi

frontal fibrosing alopecia hypertrichosis minoxidil hydrocortisone butyrate 17a-estradiol topical lotion terminal hairs vellus-like hair scarring band hair follicles fibrosis FFA Rogaine corticosteroid estradiol

From the encyclopedia

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Hydrocortisone Butyrate →

Estradiol →

an estrogen promoting hair regrowth more commonly used in women

Studysummary A woman with frontal fibrosing alopecia experienced unusual hair growth after using a specific topical lotion.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

A 60-year-old female with frontal fibrosing alopecia (FFA) exhibited a unique case of hypertrichosis after 6 months of treatment with a topical lotion containing 2% minoxidil, 0.08% hydrocortisone butyrate, and 0.05% 17a-estradiol. The patient showed increased hair growth at the anterior margins of the frontotemporal scarring band, with some terminal hairs present in the scarring area. This pattern of hypertrichosis, characterized by vellus-like hair adjacent to the alopecic area and terminal hair within the scarring band, had not been previously reported in FFA patients. The study suggested that minoxidil-induced hair growth might affect only non-affected adjacent hair follicles due to the irreversible replacement of vellus-like hair follicles by fibrosis in the affected area. Further research was recommended to better understand the pathophysiological mechanisms of FFA and develop effective treatments.

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Research cited in this study

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research Unusual Patterns of Presentation of Frontal Fibrosing Alopecia: A Clinical and Trichoscopic Analysis of 98 Patients

18 citations , June 2017 in “Journal of The American Academy of Dermatology”

In this study, trichoscopy consistently identified typical findings of frontal fibrosing alopecia, revealing three unusual clinical patterns in 18.4% of patients, which may aid in the differential diagnosis when clinical presentations are atypical.

research It's Not All Traction: The Pseudo 'Fringe Sign' in Frontal Fibrosing Alopecia

39 citations , July 2015 in “British Journal of Dermatology”

This article discusses the pseudo 'fringe sign' in frontal fibrosing alopecia, highlighting that it is not solely related to traction, and it reports no new clinical results.

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1 citations , May 2014 in “European Journal of Inflammation”

This study found that a topical lotion containing minoxidil, hydrocortisone butyrate, and 17α-estradiol improved or stabilized frontal fibrosing alopecia in 35 out of 40 women over 36 months.

research Medical Treatments for Male and Female Pattern Hair Loss

212 citations , September 2008 in “Journal of The American Academy of Dermatology”

This review discusses the various treatment options for male and female pattern hair loss and provides no new clinical results; the authors outline the most effective strategies based on existing evidence.

research Frontal Fibrosing Alopecia in Postmenopausal Women

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

This study observed that frontal fibrosing alopecia in postmenopausal women involves selective follicular inflammation, and finasteride treatment may slow disease progression, suggesting a potential androgen-related component.

research Hypertrichosis in Females Applying Minoxidil Topical Solution and in Normal Controls

63 citations , April 2003 in “Journal of The European Academy of Dermatology and Venereology”

This study found that minoxidil topical solution was associated with a dose-related occurrence of hypertrichosis, especially facial hair, in women treated for androgenetic alopecia.

research Postmenopausal Frontal Fibrosing Alopecia

325 citations , June 1994 in “Archives of Dermatology”

This study observed that progressive frontal recession in postmenopausal women may exhibit features of fibrosing alopecia, suggesting a distinct reaction pattern from typical lichen planopilaris.