Zhang May, Zhang Lily, Rosman Ilana S, Mann Caroline M
Department of Dermatology, Kaiser Permanente, Wailuku, Hawaii, USA.
Department of Pathology and Immunology, Washington University, USA.
Cutis. 2019 Feb;103(2):E16-E22.
Frontal fibrosing alopecia (FFA) is a form of scarring alopecia whose diagnosis is increasing globally. Although its etiology is unknown, FFA is thought to be a clinical subset of lichen planopilaris (LPP) that primarily affects postmenopausal women. Patients diagnosed with FFA between January 2006 and December 2013 at clinics of the Washington University Division of Dermatology (St. Louis, Missouri) were studied using patient surveys and chart notes to assess demographics, clinical features, medical history, and treatment. Twenty-nine patients were enrolled in the study, including 28 women and 1 man. The average age of disease onset was 55.4 years (range, 29-75 years). Many patients (55%) had a history of autoimmune diseases, including hypothyroidism (35%), mucocutaneous lichen planus (28%), psoriasis (7%), vitiligo (3%), systemic lupus erythematosus (3%), iritis (3%), Sjögren syndrome (3%), and ulcerative colitis (3%). Patients often identified a stressful inciting event prior to onset of hair loss. Patients tried an average of 3 different treatments for hair loss, with topical and intralesional steroids, hydroxychloroquine, topical calcineurin inhibitors, and excimer laser therapy being the most efficacious at limiting hair loss.
额部纤维性脱发（FFA）是瘢痕性脱发的一种形式，其诊断在全球范围内日益增多。尽管其病因不明，但FFA被认为是扁平苔藓性毛囊病（LPP）的一个临床亚型，主要影响绝经后女性。我们利用患者调查问卷和病历记录，对2006年1月至2013年12月期间在华盛顿大学皮肤科诊所（密苏里州圣路易斯）被诊断为FFA的患者进行研究，以评估其人口统计学特征、临床特征、病史和治疗情况。共有29名患者纳入研究，其中包括28名女性和1名男性。疾病发病的平均年龄为55.4岁（范围为29 - 75岁）。许多患者（55%）有自身免疫性疾病史，包括甲状腺功能减退（35%）、黏膜皮肤扁平苔藓（28%）、银屑病（7%）、白癜风（3%）、系统性红斑狼疮（3%）、虹膜炎（3%）、干燥综合征（3%）和溃疡性结肠炎（3%）。患者常在脱发开始前经历过应激性诱发事件。患者平均尝试过3种不同的脱发治疗方法，其中外用和皮损内注射类固醇、羟氯喹、外用钙调神经磷酸酶抑制剂和准分子激光治疗在限制脱发方面最为有效。
