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Frontal fibrosing alopecia - Hair and Scalp
Other Resources UpToDate PubMed

Frontal fibrosing alopecia - Hair and Scalp

Contributors: Vivian Wong MD, PhD, Mary Gail Mercurio MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Frontal fibrosing alopecia (FFA) is a form of scarring alopecia that presents as a progressive, symmetric band-like zone of hair loss along the anterior hairline. The eyebrows are often thinned or absent. It is considered a variant of lichen planopilaris in a patterned distribution. Women aged 55-65 years are most commonly affected, but younger women and men may be affected as well. A positive family history has been reported in 8% of cases.

There may be facial skin involvement (eg, perifollicular erythema or papules surrounding vellus hairs) in some cases, which may precede alopecia. Mucocutaneous lichen planus has occurred in up to 15% of cases.

There is a higher incidence of early menopause and history of hysterectomy without hormonal abnormalities on laboratory testing in affected women. Association with autoimmune conditions, such as vitiligo and hypothyroidism, has also been found. A recent study suggests that there is a possible link between sunscreen and moisturizer use and FFA, but the mechanism is unclear.

Codes

ICD10CM:
L66.9 – Cicatricial alopecia, unspecified

SNOMEDCT:
717055000 – Frontal fibrosing alopecia

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Female pattern alopecia
  • Male pattern alopecia
  • Traction alopecia
  • Keratosis follicularis spinulosa decalvans
  • Alopecia areata

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:01/09/2022
Last Updated:11/01/2022
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Patient Information for Frontal fibrosing alopecia - Hair and Scalp
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Frontal fibrosing alopecia - Hair and Scalp
A medical illustration showing key findings of Frontal fibrosing alopecia : Frontal scalp, Sparse eyebrows, Temporal scalp, Pruritus
Clinical image of Frontal fibrosing alopecia - imageId=4055699. Click to open in gallery.  caption: 'A band of scarring alopecia at the anterior scalp line with few remaining hairs in scarred areas (the "lonely hair" sign). There is significant perifollicular scale and some erythema on the scalp posterior to this band.'
A band of scarring alopecia at the anterior scalp line with few remaining hairs in scarred areas (the "lonely hair" sign). There is significant perifollicular scale and some erythema on the scalp posterior to this band.
Copyright © 2024 VisualDx®. All rights reserved.