Predictive Factors of Progression in Frontal Fibrosing Alopecia
Frontal fibrosing alopecia is a lymphocytic cicatricial alopecia characterized by progressive, symmetrical frontoparietal recess usually accompanied by loss of eyebrows. The etiology is unknown but hormonal factors may be implicated, as it is more prevalent in women (particularly among postmenopausal women) as well as environmental factors (all cases were reported in the last decades). Its increasing incidence and the irreversibility of this alopecia make it crucial to detect activity signs that are predictors of progression, determining, in such cases, an aggressive therapeutic approach. Based on a literature search the authors found the following factors that are predictors of progression: clinically, the diffuse variant of the disease and the fast development of alopecia worsen the prognosis; younger age of onset seems to correlate with a less severe disease course. In trichoscopy, perifollicular scaling and peri and interfollicular erythema are activity markers and probably, predictors of progression in frontal area but they are not observed in the temporal region even in cases of fast evolution.
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