Abstract
Frontal Fibrosing Alopecia (FFA) is a condition described in 1994 affect mainly postmenopausal women. It is the most common form of cicatricial alopecia considered as a follicular variant of lichen planopilaris [1]. It is believed that the main pathogenesis in this condition is related to dihydrotestosterone, a derivative converted from the testosterone through 5-Alpha- Reductase (5AR). Because inflammatory, autoimmune, and other organisms are thought to be associated with FFA, there is no one specific cause that can be acted on by 5AR inhibitors [2].Currently, the therapeutic approaches are limited and the patient outcomes are poor [1]. To date, most of the reports are case reports and observational studies [3]. No randomized controlled studies are evaluating the pharmacodynamic profiles of 5AR inhibitors for FFA. The long-term safety of 5AR inhibitors in women should also be considered.
Highlights
Frontal Fibrosing Alopecia (FFA) is a condition described in 1994 affect mainly postmenopausal women
FFA is more common in women, the article did not specify whether outcomes with 5AR inhibitors were similar in men
None of the literature selected was from a grade 1 randomized double-blinded controlled study, which made these analyses at risk of multiple confounding factors, including the presence of co-existing androgenetic alopecia, concurrent treatment use with topical minoxidil and topical or intralesional corticosteroids, limited follow-up duration period, and the possibility of spontaneous disease remission or stabilization
Summary
Frontal Fibrosing Alopecia (FFA) is a condition described in 1994 affect mainly postmenopausal women. Murad et al endorsed the use of finasteride or dutasteride for the treatment of FFA by a meta-analysis of observational studies and case reports between 2005 and 2017 [3]. They graded these reports with the American College of Physicians outcome study grading system [4].
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