Pérez-Rodríguez Irma Margarita, García-Melendez Martha Elena, Eichelmann Kristian, Vázquez-Martínez Osvaldo, Ocampo-Candiani Jorge
Department of Dermatology, Hospital Universitario 'Dr. José Eleuterio González', Universidad Autónoma de Nuevo León, Monterrey, Mexico.
Case Rep Dermatol. 2013 Nov 23;5(3):357-62. doi: 10.1159/000357022. eCollection 2013.
Frontal fibrosing alopecia (FFA) is a scarring alopecia characterized by progressive recession of the frontotemporal hairline. Current treatment is aimed at stopping progression, and the combination of dutasteride and pimecrolimus is the most effective therapy. Side effects associated with dutasteride are erectile dysfunction as well as breast tenderness and enlargement, while pimecrolimus produces a burning sensation.
We present a 57-year-old postmenopausal female with a 3-year history of a scarring alopecic plaque in her frontotemporal region. Biopsy confirmed the diagnosis of FFA, and she was started on dutasteride 0.5 mg p.o. q.d., and later, topical pimecrolimus 1% b.i.d. was added. Eight months after initiating treatment, she showed hyperpigmentation on her metacarpophalangeal and interphalangeal joints, as well as on the cheeks and on the chin; dutasteride and pimecrolimus were discontinued. After 5 months of follow-up, her hyperpigmentation improved by 80% only by using photoprotection.
Because of the variable clinical course of FFA, treatment is focused on halting its progression. Several therapeutic agents have been evaluated and the combination of dutasteride and pimecrolimus has shown a high response rate. There is no reported evidence of hyperpigmentation associated with this combination.
额部纤维性脱发（FFA）是一种瘢痕性脱发，其特征为额颞部发际线进行性后移。目前的治疗旨在阻止病情进展，度他雄胺和吡美莫司联合使用是最有效的治疗方法。度他雄胺的副作用包括勃起功能障碍以及乳房压痛和增大，而吡美莫司会产生烧灼感。
我们报告一名57岁绝经后女性，其额颞部有一块瘢痕性脱发斑，病史3年。活检确诊为FFA，开始口服度他雄胺0.5毫克，每日一次，随后加用1%吡美莫司乳膏，每日两次。开始治疗8个月后，她的掌指关节和指间关节、脸颊和下巴出现色素沉着；停用度他雄胺和吡美莫司。随访5个月后，仅通过使用防晒措施，她的色素沉着改善了80%。
由于FFA的临床病程多变，治疗重点在于阻止其进展。已对多种治疗药物进行了评估，度他雄胺和吡美莫司联合使用显示出较高的有效率。尚无关于这种联合用药导致色素沉着的报道。
