Frontal Fibrosing Alopecia

Abstract

First described by Kossard in 1994, frontal fibrosing alopecia is a type of cicatricial alopecia that is clinically characterized by progressive and symmetrical recession of the frontotemporal hairline. It is accompanied by partial alopecia of the eyebrows in most cases and loss of body hair in a variable number of patients. It is more frequent in postmenopausal women, although there have been reports of cases in men and premenopausal women. Histopathology shows it to be a variant of lichen planopilaris, which is characterized by a reduced number of hair follicles, a perifollicular lymphocytic inflammatory infiltrate, and fibrosis. Few published studies describe the dermoscopic features of frontal fibrosing alopecia. We report the case of a 51-year-old woman who consulted with a 12-month history of hair loss at the frontal hairline. No other symptoms or associated diseases were present. Physical examination revealed a bald patch in the form of a band that delimited the hairline of the frontal region (Fig. 1). She also had partial alopecia of the eyebrows. The remaining findings were normal. The patient had previously taken high-potency topical corticosteroids and 2% minoxidil with no signs of improvement. Dermoscopy (Dermlite 00 multispectral) highlighted a marked reduction in the number of follicular ostia in the central area and erythema, perifollicular desquamation, and perifollicular blue-gray dots at the border of the patch (Fig. 2). A biopsy specimen was taken, and histopathology revealed a marked reduction in the density of the