Souza Gessienne Clívia Alves E, Cortez de Almeida Rita Fernanda, Melo Daniel Fernandes
Department of Dermatology, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil.
Skin Appendage Disord. 2024 Oct;10(5):357-362. doi: 10.1159/000538795. Epub 2024 May 23.
Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia characterized by progressive recession of the frontotemporal hairline, affecting mainly postmenopausal and, lately, premenopausal women of African descent. Considering the importance of trichoscopy on FFA diagnosis and the peculiarities found in patients with higher skin phototypes, this study aimed to review the FFA trichoscopy in the black scalp (Fitzpatrick IV-VI), a topic that remains sparsely described in the existing literature.
In black patients, FFA may manifest singular features on presentation posing diagnostic clinical and trichoscopic challenges. This group has lower prevalence of the FFA compared to other alopecias. It may have an earlier age of onset and often exhibits more severe manifestations due to the coexistence of other types of alopecia and delay in diagnosis. The early signs of the disease in black patients may manifest in the eyebrows before scalp hair loss and lichen planus pigmentosus may be a herald sign.
Our research analyzes FFA trichoscopy findings in black patients to help precise diagnosis and treatment. Raising awareness of the disease characteristics on trichoscopy contributes to improving hair care in this population.
额部纤维性秃发（FFA）是一种原发性淋巴细胞性瘢痕性秃发，其特征为额颞部发际线进行性后移，主要影响绝经后以及近来有非洲血统的绝经前女性。考虑到毛发镜检查对FFA诊断的重要性以及皮肤光型较高的患者中发现的特殊情况，本研究旨在回顾黑色头皮（Fitzpatrick IV - VI型）的FFA毛发镜检查情况，这一主题在现有文献中描述较少。
在黑人患者中，FFA在表现上可能具有独特特征，给临床诊断和毛发镜检查带来挑战。与其他秃发类型相比，该组FFA的患病率较低。它可能发病年龄较早，并且由于其他类型秃发的共存和诊断延迟，常表现出更严重的症状。黑人患者疾病的早期迹象可能在头皮脱发之前先出现在眉毛上，色素性扁平苔藓可能是一个先兆体征。
我们的研究分析了黑人患者的FFA毛发镜检查结果，以帮助进行精确诊断和治疗。提高对毛发镜检查中疾病特征的认识有助于改善该人群的毛发护理。
