Hospital Dermatology Service, Ramón y Cajal Hospital, IRYCIS, Universidad de Alcalá, Madrid, Spain.
Hospital Dermatology Service, Fundación Jiménez Diaz, Madrid, Spain.
J Am Acad Dermatol. 2014 Apr;70(4):670-678. doi: 10.1016/j.jaad.2013.12.003. Epub 2014 Feb 5.
To our knowledge, there are no large multicenter studies concerning frontal fibrosing alopecia (FFA) that could give clues about its pathogenesis and best treatment.
We sought to describe the epidemiology, comorbidities, clinical presentation, diagnostic findings, and therapeutic choices in a large series of patients with FFA.
This retrospective multicenter study included patients given the diagnosis of FFA. Clinical severity was classified based on the recession of the frontotemporal hairline.
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%).
The retrospective design is a limitation.
Eyelash loss, facial papules, and body hair involvement were associated with severe FFA. Antiandrogens were the most useful treatment.
据我们所知，目前尚无大型多中心研究探讨额部纤维性脱发（FFA）的发病机制和最佳治疗方法，可为其提供线索。
我们旨在描述大量 FFA 患者的流行病学、合并症、临床表现、诊断发现和治疗选择。
这是一项回顾性多中心研究，纳入了被诊断为 FFA 的患者。根据额颞部发际线后退程度对临床严重程度进行分类。
共纳入 355 例患者（343 名女性[49 名绝经前]和 12 名男性），平均年龄 61 岁（范围 23-86 岁）。49 例（14%）患者存在早发性绝经，46 例（13%）患者行子宫切除术。131 例（37%）患者存在严重 FFA。多因素分析显示，睫毛脱落、面部丘疹和体毛受累是与严重 FFA 相关的独立因素。初始临床表现为眉毛缺失与轻度 FFA 相关。111 例患者（31%）使用了抗雄激素，如非那雄胺和度他雄胺，其中 52 例（47%）患者病情改善，59 例（53%）患者病情稳定。
回顾性设计是本研究的局限性。
睫毛脱落、面部丘疹和体毛受累与严重 FFA 相关。抗雄激素是最有效的治疗方法。
