Cervantes Jessica, Miteva Mariya
Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Skin Appendage Disord. 2018 Jan;4(1):50-54. doi: 10.1159/000479116. Epub 2017 Aug 5.
The trichoscopic features of frontal fibrosing alopecia (FFA) have been described in the frontotemporal area, yet there is no data detailing the trichoscopic features of the sideburns, which can be the initial or exclusive area of involvement. In this retrospective cohort study, 236 trichoscopic images of the frontotemporal and sideburn area obtained via dry trichoscopy from patients with biopsy-proven FFA were examined by two independent researchers to determine the trichoscopic features of FFA in the sideburns. The images of the sideburns were compared to 44 trichoscopic images of 11 healthy volunteers with intact sideburns. Transparent proximal hair emergence surrounded by patches of paler smooth skin was the most prominent finding in the sideburns. Peripilar casts and peripilar erythema were rare in the sideburns compared to the frontotemporal area. Although less common, transparent proximal hair emergence was also seen in the sideburns of healthy controls, yet it was shorter and restricted to individual hairs. Early FFA presenting exclusively or mostly with sideburn involvement should not be missed due to absence of peripilar casts and peripilar erythema. Dermoscopy-guided biopsy obtained from hair shafts with transparent proximal hair emergence should be considered to make the diagnosis in this location.
额部纤维性秃发（FFA）的毛囊镜特征已在前颞区被描述，但尚无数据详述鬓角的毛囊镜特征，而鬓角可能是最初或唯一受累区域。在这项回顾性队列研究中，两名独立研究人员检查了236张通过干式毛囊镜从经活检证实为FFA的患者颞额部和鬓角区域获取的毛囊镜图像，以确定FFA在鬓角的毛囊镜特征。将鬓角的图像与11名鬓角正常的健康志愿者的44张毛囊镜图像进行比较。鬓角最突出的表现是透明的近端毛发穿出，周围有淡色光滑皮肤斑块。与颞额部区域相比，鬓角处毛囊周痂和毛囊周红斑较少见。虽然较少见，但透明的近端毛发穿出在健康对照者的鬓角处也可见，不过其较短且局限于个别毛发。对于仅或主要累及鬓角的早期FFA，不应因缺乏毛囊周痂和毛囊周红斑而漏诊。对于有透明近端毛发穿出的毛干，应考虑在该部位进行皮肤镜引导下活检以明确诊断。
