Document Detail

Frontal fibrosing alopecia: a clinical review of 36 patients.
MedLine Citation:
PMID:  20698851     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Frontal fibrosing alopecia (FFA) is a primary lymphocytic cicatricial alopecia with a distinctive clinical pattern of progressive frontotemporal hairline recession. Currently, there are no evidence-based studies to guide treatment for patients with FFA; thus, treatment options vary among clinicians.
OBJECTIVES: We report clinical findings and treatment outcomes of 36 patients with FFA, the largest cohort to date. Further, we report the first evidence-based study of the efficacy of hydroxychloroquine in FFA using a quantitative clinical score, the Lichen Planopilaris Activity Index (LPPAI).
METHODS: A retrospective case note review was performed of 36 adult patients with FFA. Data were collected on demographics and clinical findings. Treatment responses to hydroxychloroquine, doxycycline and mycophenolate mofetil were assessed using the LPPAI. Adverse events were monitored.
RESULTS: Most patients in our cohort were female (97%), white (92%) and postmenopausal (83%). Apart from hairline recession, 75% also reported eyebrow loss. Scalp pruritus (67%) and perifollicular erythema (86%) were the most common presenting symptom and sign, respectively. A statistically significant reduction in signs and symptoms in subjects treated with hydroxychloroquine (P < 0·05) was found at both 6- and 12-month follow up.
CONCLUSIONS: In FFA, hairline recession, scalp pruritus, perifollicular erythema and eyebrow loss are common at presentation. Despite the limitations of a retrospective review, our data reveal that hydroxychloroquine is significantly effective in reducing signs and symptoms of FFA after both 6 and 12 months of treatment. However, the lack of a significant reduction in signs and symptoms between 6 and 12 months indicates that the maximal benefits of hydroxychloroquine are evident within the first 6 months of use.
A Samrao; A-L Chew; V Price
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of dermatology     Volume:  163     ISSN:  1365-2133     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-18     Completed Date:  2011-04-11     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1296-300     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. BJD © 2010 British Association of Dermatologists.
Department of Dermatology, University of California San Francisco, San Francisco, CA 94115, USA.
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MeSH Terms
Aged, 80 and over
Alopecia* / drug therapy,  pathology
Anti-Bacterial Agents / therapeutic use*
Cohort Studies
Dermatologic Agents / therapeutic use*
Doxycycline / therapeutic use
Enzyme Inhibitors / therapeutic use*
Eyebrows / pathology
Hydroxychloroquine / therapeutic use*
Middle Aged
Mycophenolic Acid / analogs & derivatives,  therapeutic use
Pruritus / pathology
Retrospective Studies
Scalp / pathology
Severity of Illness Index
Time Factors
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Dermatologic Agents; 0/Enzyme Inhibitors; 118-42-3/Hydroxychloroquine; 24280-93-1/Mycophenolic Acid; 564-25-0/Doxycycline; 9242ECW6R0/mycophenolate mofetil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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