Clinical and Dermoscopic Approaches to Diagnosis of Frontal Fibrosing Alopecia: Results From a Multicenter Study of the International Dermoscopy Society

Clinical and Dermoscopic Approaches to Diagnosis of Frontal Fibrosing Alopecia: Results From a Multicenter Study of the International Dermoscopy Society

Authors

  • Michela Starace Department of Experimental, Diagnostic, and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
  • Gloria Orlando Department of Medicine - DIMED, Dermatology Unit, University of Padova, Italy
  • Matilde Iorizzo Private Dermatology Practice, Bellinzona, Lugano, Switzerland
  • Aurora Alessandrini Department of Experimental, Diagnostic, and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
  • Francesca Bruni Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
  • Victor Desmond Mandel Dermatology Unit, Surgical, Medical, and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy; Dermatology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
  • Kelati Awatef Dermatology Department, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
  • Horacio Cabo Dermatology Division of the Instituto de Investigaciones Médicas Alfredo Lanari, University of Buenos Aires (UBA), Argentina
  • Gabriella Fabbrocini Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II
  • Baybay Hanane Dermatology Department, UHC Hassan II. Fez, Morocco
  • Sven Lanssens Dermatologie Maldegem – Maldegem, Belgium
  • Alejandro Lobato-Berezo Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
  • Fatima Zahra Mernissi Department of Dermatology, UHC Hassan II. FEZ, Morocco
  • John Paoli Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
  • Angela Patrí Department of Clinical Medicine and Surgery, Section of Dermatology, University of Naples Federico II
  • Emilia Noemi Cohen Sabban Dermatology Division of the Instituto de Investigaciones Médicas Alfredo Lanari, University of Buenos Aires (UBA), Argentina
  • Martyna Sławińska Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Poland
  • Michał Sobjanek Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Poland
  • Oscar Zaar Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Dermatology and Venereology, Gothenburg, Sweden
  • Giovanni Pellacani Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy; Dermatologic Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
  • Bianca Maria Piraccini Department of Experimental, Diagnostic, and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy

Keywords:

frontal fibrosing alopecia, trichoscopy, techniques, diagnosis, non-invasive

Abstract

Introduction: Frontal fibrosing alopecia (FFA) is a form of primary lymphocytic scarring alopecia characterized by a progressive recession of the fronto-temporal hairline. Although the clinical presentation of FFA is very typical, biopsy for histopathological examina­tion is still recommended to confirm the diagnosis. Currently, a growing number of skin and mucosal inflammatory diseases are diagnosed with modern noninvasive techniques such as dermoscopy without the necessity of a biopsy.

Objectives: The International Dermoscopy Society (IDS) aimed to test the ability of its members to diagnose classic FFA through clinical and dermoscopic parameters and to compare acquired data to the largest cohort studies published since 1994.

Methods: This is an observational, cross-sectional study describing patient demographics, clinical presentation and diagnostic tools used in a sample of FFA patients collected by IDS members. A literature search was then performed using Pubmed to review studies reporting more than 100 cases.

Results: IDS members submitted 188 cases demonstrating a predominant female population (98.4%). In 71.8% of the cases, the clinical presentation and the trichoscopic findings allowed for the diagnosis. Out of 24 revised studies, 13 showed that clinical and trichoscopic features were decisive for the diagnosis in almost all cases.

Conclusions: Demographic and clinical data of our cohort were mostly comparable to previous reported data on FFA. The relevant role of the clinical and trichoscopic features in diagnosing FFA was confirmed by our study and the reviewed literature. Trichoscopy could be considered a worldwide-acknowledged non-invasive technique for the diagnosis of FFA.

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2022-02-02

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1.
Clinical and Dermoscopic Approaches to Diagnosis of Frontal Fibrosing Alopecia: Results From a Multicenter Study of the International Dermoscopy Society. Dermatol Pract Concept [Internet]. 2022 Feb. 2 [cited 2024 Dec. 5];12(1):e2022080. Available from: https://dpcj.org/index.php/dpc/article/view/1933

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