Frontal fibrosing alopecia: clinical and prognostic classification

Abstract

Background

Frontal fibrosing alopecia (FFA) is a chronic scarring alopecia with an unpredictable evolution. There are no current classifications of this disease that may predict its prognosis.

Objective

To analyze the differences in clinical presentation and evolution of FFA patients and to create a clinical and prognostic classification

Methods

We conducted a retrospective analytical study of FFA patients. Clinical characteristics of frontal hairline recession were used as the sorting variable between patterns of presentation. A cohort of 106 patients homogenously treated with oral dutasteride and topical corticosteroid was followed 12 months.

Results

In all, 242 female patients with a mean age of 61.4 years were included. Patients were classified in three clinical patterns (118 (48.8%) patients as pattern I (linear), 109 patients (45%) as pattern II (diffuse) and 15 patients (6.2%) as pattern III (double-line)). Stabilization was achieved in 37.3% of the 106 patients treated with oral dutasteride and topical corticosteroid. Pattern III patients had less hairline recession and eyebrow involvement at the diagnosis and after treatment.

Limitations

Retrospective design.

Conclusions

FFA patients can be classified in three different clinical patterns with different prognosis. Pattern III patients have the best prognosis, while pattern II patients have the worst prognosis.

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