References: Hair growth and hair loss
Ann Dermatol Venereol. 2003 Jun-Jul;130(6-7):607-10.
[Postmenopausal frontal fibrosing alopecia: 20 cases]
[Article in French]
Vaisse V, Matard B, Assouly P, Jouannique C, Reygagne P.
Unite de Dermatologie, Hopital Tenon, 4, rue de la Chine, 75020 Paris.
INTRODUCTION: Postmenopausal frontal fibrosing alopecia is a scarring alopecia that has been recently described by Kossard in 1994 and rarely reported in the literature. OBSERVATIONS: We have conducted a retrospective clinical and histological study of a series of 20 cases of postmenopausal frontal fibrosing alopecia. The results, in agreement with those in the literature, revealed the stereotyped nature of this entity. DISCUSSION: All the clinical and histological data suggest that postmenopausal frontal fibrosing alopecia is a clinical form of lichen planopilaris occurring in elderly women. As with lichen planopilaris its physiopathology is unknown. However, in analogy with other lichen-like dermatoses, a lymphocyte T-mediated autoimmune reaction appears to play a predominant part in its genesis.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=13679696&dopt=Abstract
Arch Dermatol. 1994 Jun;130(6):770-4.
Postmenopausal frontal fibrosing alopecia. Scarring alopecia in a pattern distribution.
Kossard S.
Skin and Cancer Foundation, Sydney, Australia.
BACKGROUND: Recession of the frontal hairline is a common event in postmenopausal women. This has been shown not to be a marker of gross androgenization, and is usually a progressive nonscarring alopecia. Six postmenopausal women, who developed a progressive frontal scarring alopecia, were studied and their clinical and laboratory data, as well as the results of scalp biopsy specimens in all six patients, were analyzed and compared with recognized forms of scarring alopecia and recently described findings in androgenetic alopecia. OBSERVATIONS: The six postmenopausal women developed a progressive frontal hairline recession that was associated with perifollicular erythema within the marginal hairline, producing a frontal fibrosing alopecia extending to the temporal and parietal hair margins. Scalp biopsy specimens from the frontal hair margin showed perifollicular fibrosis and lymphocytic inflammation concentrated around the isthmus and infundibular areas of the follicles. Immunophenotyping of the lymphocytes showed a dominance of activated T-helper cells. Clinical review of all six cases showed a progressive marginal alopecia without the typical multifocal areas of involvement seen in lichen planopilaris or pseudopelade. None of the patients had mucous membrane or skin lesions typical of lichen planus. Hormonal studies, in five patients, showed no elevated androgen abnormalities. CONCLUSIONS: Progressive frontal recession in postmenopausal women may show clinical features of a fibrosing alopecia. The histologic findings are indistinguishable from those seen in lichen planopilaris. However, the absence of associated lesions of lichen planus in all six women raises the possibility that this mode of follicular destruction represents a reaction pattern triggered by the events underlying postmenopausal frontal hairline recession.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8002649&dopt=Abstract
J Am Acad Dermatol. 1997 Jan;36(1):59-66.
Postmenopausal frontal fibrosing alopecia: a frontal variant of lichen planopilaris.
Kossard S, Lee MS, Wilkinson B.
Skin and Cancer Foundation Australia, NSW, Australia.
BACKGROUND: Lichen planopilaris usually produces multifocal areas of scarring alopecia. Recently, a condition in postmenopausal women characterized by progressive frontal hairline recession associated with scarring has been described. OBJECTIVE: Our purpose was to study the clinical and histopathologic features and results of treatment in a group of women with the frontal variant of lichen planopilaris and to compare the immunohistochemical profile of scalp biopsy specimens from this subset with that found in the multifocal variant of lichen planopilaris. METHOD: The clinical data as well as the histopathologic findings in 16 women with frontal fibrosing alopecia were collated. The immunohistochemical profile of six scalp biopsy specimens from the frontal hairline were compared with six specimens from women with multifocal lichen planopilaris. RESULTS: In addition to the progressive frontal fibrosing alopecia in all 16 women, total loss or a marked decrease of the eyebrows was observed in 13. No evidence of lichen planus was observed at other sites. In one patient multifocal areas of lichen planopilaris developed in the scalp. The frontal fibrosing alopecia was slowly progressive but has stabilized in five patients. Biopsy specimens from the frontal hairline showed histologic changes identical to lichen planopilaris. Immunophenotyping failed to reveal any significant differences between the frontal and multifocal variants. No effective treatments emerged although oral steroids and antimalarials may temporarily slow the course. Hormone replacement therapy did not appear to influence the course of the alopecia. CONCLUSION: Progressive frontal fibrosing alopecia is a clinically distinct variant of lichen planopilaris that affects in particular elderly women and frequently involves the eyebrows. The basis for this lichenoid tissue reaction targeting frontal scalp follicles and eyebrows is unknown.
online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8996262&dopt=Abstract
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