Lonely Hair
October 2011
in “
Archives of Dermatology
”
Frontal Fibrosing Alopecia FFA lichen planopilaris scarring alopecia postmenopausal women bandlike alopecia frontal hairline eyebrows lichenoid infiltrate perifollicular fibrosis apoptotic keratinocytes terminal hairs perifollicular erythema scaling traction alopecia alopecia areata androgenetic alopecia scarring hair loss frontal hair loss eyebrow hair loss hairline recession hair thinning hair shedding
TLDR Isolated long hairs at the original hairline can help diagnose Frontal Fibrosing Alopecia.
The document discusses Frontal Fibrosing Alopecia (FFA), a variant of lichen planopilaris that primarily affects postmenopausal women, characterized by a progressive bandlike scarring alopecia at the frontal hairline and eyebrows. A case of a 45-year-old white woman with a 2-year history of progressive hair loss is presented, where clinical examination revealed a band of alopecia with regression of the frontal hairline and sparse eyebrows. Pathologic examination confirmed FFA, showing a lichenoid infiltrate at the upper follicle level, perifollicular fibrosis, and apoptotic keratinocytes. The presence of isolated terminal hairs in the midfrontal area, where the original hairline was, is highlighted as a clinical clue for diagnosing FFA. A retrospective review of 39 patients with biopsy-proven FFA found that 30 patients had these isolated hairs, which can be 3 to 7 cm long and may appear with or without perifollicular erythema and scaling. This finding is important for differentiating FFA from other conditions like traction alopecia, alopecia areata, and androgenetic alopecia, aiding dermatologists in diagnosis.
