Owczarek Michał, Jałowska Magdalena, Mariowska Agnieszka, Grochowska Wiktoria, Szyszkowska Joanna, Metelkina Daria, Spałek Maciej Marek
Department of Dermatology, Poznan University of Medical Sciences, 60-355 Poznan, Poland.
Department of Psychology, University of Warsaw, 00-183 Warsaw, Poland.
J Clin Med. 2025 Jun 18;14(12):4346. doi: 10.3390/jcm14124346.
: Frontal fibrosing alopecia (FFA) is a scarring alopecia with an unclear aetiology, primarily affecting postmenopausal women. This study aims to identify potential risk factors contributing to FFA development and progression, as well as provide a clinical profile to aid in the differential diagnosis. : The study included 19 women diagnosed with FFA. The participants completed a 20-question survey based on a literature review of potential risk factors. Statistical analyses were performed to investigate the associations between patient characteristics and FFA. : All patients were female and their mean age was 60.58 years (SD = 12.81). In 63.1% of the cases, FFA onset occurred postmenopause, with a mean latency of 8.17 years. In the majority of cases, the diagnostic delay exceeded five years. The average menarche age was 13.68 years (SD = 2.06), whereas late menarche (≥15 years) was found in two subjects. A history of reproductive organ or breast malignancy was reported by 42.1% of the patients, which frequently required surgery. Most subjects did not receive hormone replacement therapy, or hormonal contraception. The most prevalent comorbidity was hypothyroidism (89.47%). Although smoking was rare among the subjects, hair colouring was quite common, yet no participant underwent scalp aesthetic procedures. In 47.4% of cases, scalp itching or pain was present. Sunscreens were frequently used, mostly on a daily or seasonal basis. : FFA predominantly affects women in their early 60s, often following the menopause. In our study, a tendency toward an early menopause and an above-average menarche age of the subjects was observed. In the analysed group, only reproductive and breast cancers were reported, which requires further investigation. Frequent β-blocker use, second only to levothyroxine, may suggest that they play a role in FFA pathogenesis. Itching and pain of the scalp may contribute to the correct diagnosis, although these symptoms are not universal. Moreover, sunscreens were indicated as a potential trigger, yet avoiding them should not be routinely recommended due to the risk of carcinogenesis. The variability in the diagnostic delay emphasises the need for increasing clinician awareness and conducting further research.
额部纤维性秃发(FFA)是一种病因不明的瘢痕性秃发,主要影响绝经后女性。本研究旨在确定导致FFA发生和进展的潜在危险因素,并提供有助于鉴别诊断的临床特征。
该研究纳入了19名被诊断为FFA的女性。参与者基于对潜在危险因素的文献综述完成了一项包含20个问题的调查。进行了统计分析以研究患者特征与FFA之间的关联。
所有患者均为女性,平均年龄为60.58岁(标准差=12.81)。在63.1%的病例中,FFA在绝经后发病,平均潜伏期为8.17年。在大多数病例中,诊断延迟超过5年。平均初潮年龄为13.68岁(标准差=2.06),有两名受试者初潮较晚(≥15岁)。42.1%的患者报告有生殖器官或乳腺恶性肿瘤病史,且经常需要手术。大多数受试者未接受激素替代疗法或激素避孕。最常见的合并症是甲状腺功能减退(89.47%)。虽然受试者中吸烟情况少见,但染发很常见,然而没有参与者接受过头皮美容手术。在47.4%的病例中,存在头皮瘙痒或疼痛。防晒剂经常使用,大多是每天或季节性使用。
FFA主要影响60岁出头的女性,通常在绝经后出现。在我们的研究中,观察到受试者有早绝经和初潮年龄高于平均水平的趋势。在分析的组中,仅报告了生殖系统和乳腺癌,这需要进一步研究。频繁使用β受体阻滞剂仅次于左甲状腺素,这可能表明它们在FFA发病机制中起作用。头皮瘙痒和疼痛可能有助于正确诊断,尽管这些症状并不普遍。此外,防晒剂被认为是一个潜在触发因素,但由于有致癌风险,不应常规建议避免使用。诊断延迟的变异性强调了提高临床医生意识并开展进一步研究的必要性。