Frontal Fibrosing Alopecia

S Vañó-Galván, AM Molina-Ruiz, C Serrano-Falcón, S Arias-Santiago, AR Rodrigues-Barata, G Garnacho-Saucedo, A Martorell-Calatayud, P Fernández-Crehuet, R Grimalt, B Aranegui, E Grillo, B Diaz-Ley, R Salido, S Pérez-Gala, S Serrano, JC Moreno, P Jaén, FM Camacho

Frontal alopeciaABSTRACT

BACKGROUND
To our knowledge, there are no large multicenter studies concerning frontal fibrosing alopecia (FFA) that could give clues about its pathogenesis and best treatment.

OBJECTIVE
We sought to describe the epidemiology, comorbidities, clinical presentation, diagnostic findings, and therapeutic choices in a large series of patients with FFA.

METHODS
This retrospective multicenter study included patients given the diagnosis of FFA. Clinical severity was classified based on the recession of the frontotemporal hairline.

RESULTS
In all, 355 patients (343 women [49 premenopausal] and 12 men) with a mean age of 61 years (range 23-86) were included. Early menopause was detected in 49 patients (14%), whereas 46 (13%) had undergone hysterectomy. Severe FFA was observed in 131 patients (37%). Independent factors associated with severe FFA after multivariate analysis were: eyelash loss, facial papules, and body hair involvement. Eyebrow loss as the initial clinical presentation was associated with mild forms. Antiandrogens such as finasteride and dutasteride were used in 111 patients (31%), with improvement in 52 (47%) and stabilization in 59 (53%).

LIMITATIONS
The retrospective design is a limitation.

CONCLUSIONS
Eyelash loss, facial papules, and body hair involvement were associated with severe FFA. Antiandrogens were the most useful treatment.

S Vañó-Galván, AM Molina-Ruiz, C Serrano-Falcón, S Arias-Santiago, AR Rodrigues-Barata, G Garnacho-Saucedo, A Martorell-Calatayud, P Fernández-Crehuet, R Grimalt, B Aranegui, E Grillo, B Diaz-Ley, R Salido, S Pérez-Gala, S Serrano, JC Moreno, P Jaén, FM Camacho.
Frontal Fibrosing Alopecia: A Multicenter Review of 355 Patients. J Am Acad Dermatol 2014 Feb 05;[EPub Ahead of Print]