Antiandrogenic drugs, a therapeutic option for frontal fibrosing alopecia patients

Abstract

To the Editor: We thank Dr Tziotzios and colleagues1Tziotzios C. Fenton D. Stefanato C. McGrath J. Finasteride is of uncertain utility in treating frontal fibrosing alopecia.J Am Acad Dermatol. 2016; 74: e73-e74Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar for the comments on our article.2Vañó-Galván S. Molina-Ruiz A.M. Serrano-Falcón C. et al.Frontal fibrosing alopecia: a multicenter review of 355 patients.J Am Acad Dermatol. 2014; 70: 670-678Abstract Full Text Full Text PDF PubMed Scopus (304) Google Scholar We want to clarify some points about the potential usefulness of oral antiandrogens (OA) in the treatment of frontal fibrosing alopecia (FFA):•FFA patients without androgenetic alopecia (AGA) treated with OA may also benefit from this treatment. In fact, stabilization of the disease or even better effect was observed in the 10 FFA patients without AGA treated solely with OA in our study.2Vañó-Galván S. Molina-Ruiz A.M. Serrano-Falcón C. et al.Frontal fibrosing alopecia: a multicenter review of 355 patients.J Am Acad Dermatol. 2014; 70: 670-678Abstract Full Text Full Text PDF PubMed Scopus (304) Google Scholar, 3Vaño-Galván S. Arias-Santiago S. Camacho F. Reply to ‘frontal fibrosing alopecia’.J Am Acad Dermatol. 2014; 71: 594-595Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar•Tziotzios and colleagues1Tziotzios C. Fenton D. Stefanato C. McGrath J. Finasteride is of uncertain utility in treating frontal fibrosing alopecia.J Am Acad Dermatol. 2016; 74: e73-e74Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar raise awareness about the adverse effects of OA, especially the risk of developing breast cancer. Nevertheless, recent studies have attested to the safety of these drugs.4Gupta A.K. Charrette A. The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit-risk assessment of finasteride and dutasteride.J Dermatolog Treat. 2014; 25: 156-161Crossref PubMed Scopus (66) Google Scholar, 5Duijnhoven R.G. Straus S.M. Souverein P.C. et al.Long-term use of 5α-reductase inhibitors and the risk of male breast cancer.Cancer Causes Control. 2014; 25: 1577-1582Crossref PubMed Scopus (25) Google Scholar, 6Bird S.T. Brophy J.M. Hartzema A.G. Delaney J.A. Etminan M. Male breast cancer and 5α-reductase inhibitors finasteride and dutasteride.J Urol. 2013; 190: 1811-1814Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar•There is increasing evidence2Vañó-Galván S. Molina-Ruiz A.M. Serrano-Falcón C. et al.Frontal fibrosing alopecia: a multicenter review of 355 patients.J Am Acad Dermatol. 2014; 70: 670-678Abstract Full Text Full Text PDF PubMed Scopus (304) Google Scholar, 3Vaño-Galván S. Arias-Santiago S. Camacho F. Reply to ‘frontal fibrosing alopecia’.J Am Acad Dermatol. 2014; 71: 594-595Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar that FFA is not a pure immune-mediated disease and that an as yet unknown hormonal mechanism might play a role2Vañó-Galván S. Molina-Ruiz A.M. Serrano-Falcón C. et al.Frontal fibrosing alopecia: a multicenter review of 355 patients.J Am Acad Dermatol. 2014; 70: 670-678Abstract Full Text Full Text PDF PubMed Scopus (304) Google Scholar:○More than 95% of cases of FFA occur in females.○The majority of women diagnosed with FFA develop the disease in the perimenopausal period.○There is an increased incidence of early menopause and gynecologic surgeries in FFA patients.○OA is useful to stabilize the disease in some patients, even in monotherapy. In addition, our research group is now performing an in-depth molecular analysis of signaling pathways potentially altered in the skin of FFA patients. Indeed, our preliminary results suggest that the expression and/or function of certain gene products involved in specific sex-hormone signaling are constitutively impaired in these patients. In conclusion, OA are drugs with a well-known and acceptable profile of adverse effects may be considered as an interesting therapeutic option to offer to FFA patients. Finasteride is of uncertain utility in treating frontal fibrosing alopeciaJournal of the American Academy of DermatologyVol. 74Issue 4PreviewTo the Editor: We were interested to read the report by Danesh and Murase1 on the potential of finasteride as “a safe and alternative” treatment option for frontal fibrosing alopecia in the Journal's Therapeutic Pearls section. We note that their conclusions were based on 2 reports by Vañó-Galván et al2 and Moreno-Ramírez et al3 and we wish to highlight the following: Full-Text PDF CorrectionJournal of the American Academy of DermatologyVol. 78Issue 2PreviewVañó-Galván S, Saceda-Corralo D, Alonso-Castro L, et al. Antiandrogenic drugs, a therapeutic option for frontal fibrosing alopecia patients. J Am Acad Dermatol. 2016;74(4):e77. Full-Text PDF