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Frontal fibrosing alopecia - Hair and Scalp
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Frontal fibrosing alopecia - Hair and Scalp

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Contributors: Vivian Wong MD, PhD, Mary Gail Mercurio MD, Susan Burgin MD
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Synopsis

Frontal fibrosing alopecia : Sparse eyebrows, Focal scarring alopecia, Pruritus, Frontal hairline
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. This is considered a variant of lichen planopilaris in a patterned distribution. Women aged between 55 and 65 years are most commonly affected, but younger women and men may be affected as well. A positive family history may be 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 may occur 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.

Codes

ICD10CM:
L66.9 – Cicatricial alopecia, unspecified

SNOMEDCT:
717055000 – Frontal fibrosing alopecia

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Last Reviewed:02/13/2020
Last Updated:02/13/2020
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Frontal fibrosing alopecia - Hair and Scalp
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Frontal fibrosing alopecia : Sparse eyebrows, Focal scarring alopecia, Pruritus, Frontal hairline
Clinical image of Frontal fibrosing alopecia
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.

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