Reassessing frontal fibrosing alopecia

Abstract

Frontal fibrosing alopecia (FFA), is an acquired clinical entity characterized by a scarring, slowly progressive alopecia of the frontoparietal hairline. It is commonly accompanied by thinning or complete loss of eyebrows. Although there are only 117 cases reported, it is likely that FFA is more frequent than it has been thought as it is often misdiagnosed or not diagnosed at all. Epidemiologic data show that the disease, in the vast majority of cases, primarily affects women older than 60 years of age. The histology of FFA is indistinguishable from that of lichen planopilaris and Lassueur-Graham-Little-Piccardi syndrome, and the diagnosis depends mainly on the clinicopathologic correlation. Lymphocytic infiltration surrounding the upper portion of hair follicles confirms FFA. Treatment modalities are not efficacious. In cases where the disorder is rapidly progressive, short courses of oral prednisone or chloroquine may temporarily stabilize the disease; however, further progression after the withdrawal o...