Frontal Fibrosing Alopecia

Frontal fibrosing alopecia (FFA) is a rare variant of lichen planopilaris (see this term) characterized by symmetrical, progressive, band-like anterior hair loss of the scalp.

Epidemiology

Prevalence is unknown. It most commonly affects postmenopausal women, although it has also been reported in men and premenopausal women.

Clinical description

Progressive recession of the frontal and temporal hairline is observed. Approximately half of all cases of FFA also have eyebrow loss; less often there is hair loss in other parts of the body. It is only very rarely associated with classic lichen planus lesions elsewhere. Histopathologically, perifollicular lymphocytic infiltrate and follicular hyperkeratosis are observed at the edge of the affected area, while the rest of the lesion appears pale with loss of the follicular ostia. It is histologically indistinguishable from other forms of lichen planopilaris.

Etiology

It was suggested that the disease could have a hormonal origin, but to date the precise etiology remains unknown.