Department of Dermatology, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
Department of Dermatology, Faculty of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
An Bras Dermatol. 2022 May-Jun;97(3):348-357. doi: 10.1016/j.abd.2021.08.008. Epub 2022 Apr 2.
Lichen planopilaris and frontal fibrosing alopecia are primary scarring alopecias where diagnosis can be suggested by clinical and trichoscopy features, especially in the early stages, but scalp biopsy is the standard exam for definitive diagnosis. Frontal fibrosing alopecia is considered a variant of lichen planopilaris, as the histopathological findings are similar, with a perifollicular lymphohistiocytic infiltrate, sometimes with a lichenoid pattern. A thorough clinical examination, trichoscopy and photographic documentation are essential to assess the evolution and therapeutic response. To date, there are no validated treatments or guidelines for these diseases, but there are recommendations that vary with the individual characteristics of each patient. This article presents a comprehensive review of the literature, including an update on topics related to the diagnosis, follow-up, histopathological aspects and available treatments for lichen planopilaris and frontal fibrosing alopecia, highlighting their similarities, differences and peculiarities.
瘢痕性脱发包括斑秃和额部纤维性脱发，这两种疾病在早期阶段可以根据临床和毛发镜特征进行诊断，特别是在早期阶段，但头皮活检是明确诊断的标准检查。额部纤维性脱发被认为是斑秃的一种变异，因为组织病理学发现相似，存在毛囊周围淋巴组织细胞浸润，有时呈苔藓样模式。全面的临床检查、毛发镜检查和图像记录对于评估疾病的演变和治疗反应至关重要。迄今为止，这些疾病没有经过验证的治疗方法或指南，但有一些建议，根据每个患者的个体特征而有所不同。本文对相关文献进行了全面综述，包括对斑秃和额部纤维性脱发的诊断、随访、组织病理学方面以及现有治疗方法的更新，重点介绍了它们的相似之处、不同之处和特点。
