[Frontal fibrosing alopecia: A prospective study of 20 cases].

BACKGROUND: Frontal fibrosing alopecia (FFA) is a variant of lichen planopilaris predominantly affecting postmenopausal women. We report a series of 20 cases of FFA and describe the epidemiological, clinical, dermoscopic features and progress under treatment.

PATIENTS AND METHODS: This was a prospective study conducted over a period of 16 months in patients seen at the dermatology department of the Hassan II University in Fez, Morocco.

RESULTS: Mean patient age was 46 years. Patients were premenopausal in 65% of cases. Dermoscopic examination revealed specific signs of the disease. Skin biopsy guided by dermoscopy confirmed the diagnosis of lichen planus pilaris in its FFA variant in all cases. Immune dysfunctions and other disorders were noted in half of the cases. Various treatments had been initiated, including topical corticosteroids, tacrolimus ointment, minoxidil 2%, hydroxychloroquine, and oral finasteride. The results were satisfactory with a decline within one year.

CONCLUSION: FFA is increasingly widely described in premenopausal women. Dermoscopy may be used to facilitate diagnosis, guide biopsy, evaluate treatment efficacy and establish a prognosis.