Tecnologico de Monterrey, Campus Monterrey, Monterrey, NL, Mexico.
Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
J Eur Acad Dermatol Venereol. 2018 Feb;32(2):318-322. doi: 10.1111/jdv.14571. Epub 2017 Sep 26.
Frontal fibrosing alopecia (FFA) is a cicatricial alopecia that affects the frontotemporal hairline, eyebrows and body hair. OCT is a non-invasive imaging technique useful in understanding skin architecture and vascularization.
To describe structural and vascular findings in FFA using OCT.
This was a case-control study conducted from the months of December 2016-February 2017. The study was IRB approved and conducted at the University of Miami Hospital outpatient dermatology hair and nail clinic in Miami, FL. Four patients with biopsy proven FFA, and three healthy age and sex-matched controls participated. OCT scans were taken on cicatricial alopecic band, inflammatory hairline, eyebrow, uninvolved scalp, facial papules, glabellar red dots and arm. The same body regions were evaluated in controls.
Patients and controls were women aged 42-66. Results reveal epidermal thickness is increased in the inflammatory hairline (0.13 mm) and decreased in the alopecic band (0.08 mm) compared to controls (0.10 mm). Attenuation coefficient increased the inflammatory hairline and decreased in the alopecic band compared to controls. Vascular flow in the alopecic band is decreased compared to inflammatory scalp and controls in the superficial levels, but increased at deeper levels as compared to controls. Inflammatory tissue is consistently more vascular at all levels (P < 0.01). Vascular flows in each stage are significantly different than one another (P < 0.01).
Increased vascular flow of the deep plexus in cicatricial stages can be a consequence of superficial tissue ischaemia or fibrosis. It is difficult to establish if the increased flow in the inflammatory stage is due to neovascularization as seen in other ischaemic diseases or is the result of the inflammatory response. OCT may be a useful non-invasive tool in imaging FFA. Not only can the technology assist in monitoring disease activity in a non-invasive manner, but it may elucidate new pathophysiologic findings.
额部纤维性脱发（FFA）是一种瘢痕性脱发，影响额颞部发际线、眉毛和体毛。OCT 是一种非侵入性成像技术，有助于了解皮肤结构和血管化。
使用 OCT 描述 FFA 的结构和血管发现。
这是一项 2016 年 12 月至 2017 年 2 月进行的病例对照研究。该研究获得了机构审查委员会的批准，并在佛罗里达州迈阿密的迈阿密大学医院门诊皮肤科毛发和指甲诊所进行。四名经活检证实患有 FFA 的患者和三名年龄和性别匹配的健康对照者参与了研究。OCT 扫描在瘢痕性脱发带、炎症性发际线、眉毛、未受累头皮、面部丘疹、眉间红点和手臂上进行。在对照组中评估了相同的身体区域。
患者和对照组均为 42-66 岁的女性。结果显示，与对照组（0.10mm）相比，炎症性发际线的表皮厚度增加（0.13mm），而脱发带的表皮厚度减少（0.08mm）。与对照组相比，衰减系数在炎症性发际线增加，在脱发带减少。与炎症性头皮和对照组相比，脱发带的浅层水平的血管流量减少，但与对照组相比，深层水平的血管流量增加。在所有水平，炎症组织的血管流量均显著高于对照组（P<0.01）。每个阶段的血管流量均显著不同于其他阶段（P<0.01）。
在瘢痕期，深部丛的血管流量增加可能是浅层组织缺血或纤维化的结果。尚不清楚炎症期的流量增加是由于其他缺血性疾病中所见的新生血管形成，还是炎症反应的结果。OCT 可能是一种用于成像 FFA 的有用的非侵入性工具。该技术不仅可以以非侵入性的方式协助监测疾病活动，而且可能阐明新的病理生理发现。
