Sergio Vañó-Galván1, Ana M Molina-Ruiz2, Cristina Serrano-Falcón3, Salvador Arias-Santiago4, Ana R Rodrigues-Barata5, Gloria Garnacho-Saucedo6, Antonio Martorell-Calatayud7, Pablo Fernández-Crehuet8, Ramón Grimalt9, Beatriz Aranegui10, Emiliano Grillo11, Blanca Diaz-Ley11, Rafael Salido6, Sivia Pérez-Gala11, Salvio Serrano12, Jose Carlos Moreno6, Pedro Jaén11, Francisco M Camacho13. 1. Hospital Dermatology Service, Ramón y Cajal Hospital, IRYCIS, Universidad de Alcalá, Madrid, Spain. Electronic address: sergiovano@yahoo.es. 2. Hospital Dermatology Service, Fundación Jiménez Diaz, Madrid, Spain. 3. Hospital Dermatology Service, Guadix Hospital, Granada, Spain. 4. Hospital Dermatology Service, Baza Hospital, Granada, Spain. 5. Hospital Dermatology Service, Grupo Pedro Jaén, Madrid, Spain. 6. Hospital Dermatology Service, Reina Sofía Hospital, Córdoba, Spain. 7. Hospital Dermatology Service, Manises Hospital, Valencia, Spain. 8. Hospital Dermatology Service, Alto Guadalquivir Hospital of Andújar (Jaén), Jaén, Spain. 9. Hospital Dermatology Service, Universitat de Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain. 10. Hospital Dermatology Service, Clínica Universitaria de Navarra, Madrid, Spain. 11. Hospital Dermatology Service, Ramón y Cajal Hospital, IRYCIS, Universidad de Alcalá, Madrid, Spain. 12. Hospital Dermatology Service, Universidad de Granada, Granada, Spain. 13. Hospital Dermatology Service, Virgen Macarena Hospital, Sevilla, Spain.
Abstract
BACKGROUND: To our knowledge, there are no large multicenter studies concerning frontal fibrosing alopecia (FFA) that could give clues about its pathogenesis and best treatment. OBJECTIVE: We sought to describe the epidemiology, comorbidities, clinical presentation, diagnostic findings, and therapeutic choices in a large series of patients with FFA. METHODS: This retrospective multicenter study included patients given the diagnosis of FFA. Clinical severity was classified based on the recession of the frontotemporal hairline. RESULTS: In all, 355 patients (343 women [49 premenopausal] and 12 men) with a mean age of 61 years (range 23-86) were included. Early menopause was detected in 49 patients (14%), whereas 46 (13%) had undergone hysterectomy. Severe FFA was observed in 131 patients (37%). Independent factors associated with severe FFA after multivariate analysis were: eyelash loss, facial papules, and body hair involvement. Eyebrow loss as the initial clinical presentation was associated with mild forms. Antiandrogens such as finasteride and dutasteride were used in 111 patients (31%), with improvement in 52 (47%) and stabilization in 59 (53%). LIMITATIONS: The retrospective design is a limitation. CONCLUSIONS: Eyelash loss, facial papules, and body hair involvement were associated with severe FFA. Antiandrogens were the most useful treatment.
BACKGROUND: To our knowledge, there are no large multicenter studies concerning frontal fibrosing alopecia (FFA) that could give clues about its pathogenesis and best treatment. OBJECTIVE: We sought to describe the epidemiology, comorbidities, clinical presentation, diagnostic findings, and therapeutic choices in a large series of patients with FFA. METHODS: This retrospective multicenter study included patients given the diagnosis of FFA. Clinical severity was classified based on the recession of the frontotemporal hairline. RESULTS: In all, 355 patients (343 women [49 premenopausal] and 12 men) with a mean age of 61 years (range 23-86) were included. Early menopause was detected in 49 patients (14%), whereas 46 (13%) had undergone hysterectomy. Severe FFA was observed in 131 patients (37%). Independent factors associated with severe FFA after multivariate analysis were: eyelash loss, facial papules, and body hair involvement. Eyebrow loss as the initial clinical presentation was associated with mild forms. Antiandrogens such as finasteride and dutasteride were used in 111 patients (31%), with improvement in 52 (47%) and stabilization in 59 (53%). LIMITATIONS: The retrospective design is a limitation. CONCLUSIONS:Eyelash loss, facial papules, and body hair involvement were associated with severe FFA. Antiandrogens were the most useful treatment.
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