Frontal fibrosing alopecia: to treat or not to treat?
BACKGROUND
published studies have evaluated a variety of therapeutic agents in frontal fibrosing alopecia (FFA); however, data on whether fibrosis is already established when the patients initially present are scarce.


OBJECTIVE
to identify the prevalence of active disease in patients initially diagnosed with FFA and to evaluate the efficacy of therapeutic agents suggested in the medical literature.


METHODS
eighteen postmenopausal women with FFA presented at the outpatient clinic of our hospital from June 2003 to August 2007. Five patients who also presented with androgenetic alopecia were treated with finasteride 2.5 mg/d plus minoxidil 5% for 12 months. One patient with a rapidly regressing disease received systemic corticosteroids. The remaining 12 patients were divided into two groups: 6 patients received topical clobetasol 0.05% solution once daily for 6 months and the rest received no treatment.


RESULTS
thirteen of 18 patients presented with stable disease. No significant improvement was observed in any of the patients.


CONCLUSIONS
to date, there is no effective treatment proven with an appropriate level of evidence in the management of FFA. Exclusion criteria in future clinical studies should take into account patients presenting with stable disease. What needs to be established is whether treatment can halt or slow the progression of active disease.
Rallis
Eustathios
E
University of Athens, Department of Dermatology, A Sygros Hospital, Athens, Greece.
Gregoriou
Stamatis
S
Christofidou
Eleftheria
E
Rigopoulos
Dimitrios
D
D058891:5-alpha Reductase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000505:Alopecia / Q000188:drug therapy* / Q000473:pathology*; D004359:Drug Therapy, Combination; D005260:Female; D005355:Fibrosis; D018120:Finasteride / Q000008:administration & dosage* / Q000627:therapeutic use; D005546:Forehead; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D008875:Middle Aged; D008914:Minoxidil / Q000008:administration & dosage* / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use
D058891:5-alpha Reductase Inhibitors; D005938:Glucocorticoids; D014665:Vasodilator Agents; D018120:Finasteride; D008914:Minoxidil