Frontal fibrosing alopecia - review of recent case reports and case series in PubMed.

Background: In his initial publication of frontal fibrosing alopecia (FFA) in 1994, Steven Kossard included six postmenopausal women. A type of cicatricial alopecia, FFA is clinically characterized by frontotemporal hairline recession and loss of eyebrows. In recent years, there has been an increasing number of case reports of FFA in both premenopausal women and men.

Study Objective: Review and analysis of the literature on FFA with regard to epidemiology, associated disorders, disease presentation, diagnosis and treatment.

Methods And Material: We conducted a Pubmed database search for case reports and case series on FFA. Overall, we reviewed and analyzed data from 68 articles, including 932 patients. Apart from epidemiological data such as age, gender or ethnicity, we also assessed other aspects such as predilection sites, associated skin lesions, comorbidities, drugs and treatment response as well as the diagnostic significance of autoantibodies.

Results: While we were able to confirm and more accurately define some of the data published in the literature, we were unable to reproduce certain assumptions that had previously been made. The high coincidence of FFA and thyroid disease we found in our analysis is particularly significant.

Conclusions: The present study provides the most comprehensive review to date of published cases of FFA.