Reply to: Updated Diagnostic Criteria for Frontal Fibrosing Alopecia
December 2017
in “
Journal of The American Academy of Dermatology
”
frontal fibrosing alopecia FFA cicatricial alopecia perifollicular erythema hyperkeratosis solitary hairs histopathologic features lichen planopilaris LPP noninflammatory facial papules pruritus pain scarring alopecia redness around hair follicles thickened skin single hairs histopathology noninflammatory facial bumps itching
TLDR The authors updated the criteria for diagnosing frontal fibrosing alopecia, making it easier to diagnose without a biopsy.
In response to suggestions from Vaño-Galvan et al., the authors updated the diagnostic criteria for frontal fibrosing alopecia (FFA) based on their Mayo Clinic cohort study. They revised the major criteria to include cicatricial alopecia of the frontal, temporal, or frontotemporal scalp without follicular keratotic papules on the body, and diffuse bilateral eyebrow cicatricial alopecia. Minor criteria now include perifollicular erythema, hyperkeratosis, or solitary hairs on examination, histopathologic features of FFA or lichen planopilaris (LPP) on biopsy, involvement of additional FFA sites, noninflammatory facial papules, and preceding or concurrent symptoms like pruritus or pain. They removed the necessity of histopathology for diagnosis, downgrading it to a minor criterion, and excluded features of LPP from the criteria. The diagnosis of FFA now requires two major criteria or one major and two minor criteria. The authors acknowledged the input from Vaño-Galvan et al. and emphasized the importance of consensus in compiling diagnostic criteria.
