title: Frontal fibrosing alopecia: a retrospective review of 19 patients seen at Duke University.
abstract: BACKGROUND
  Frontal fibrosing alopecia (FFA) is a type of scarring hair loss primarily observed in postmenopausal women and characterized by fronto-tempero-parietal hairline recession, perifollicular erythema, and loss of eyebrows. The incidence is unknown, but the number of women presenting with this condition has significantly increased in recent years. No effective therapy has been established.
  
  
  OBJECTIVE
  The purpose of this study is to present pertinent demographic and clinical findings of patients with FFA seen at an academic hair loss clinic and their responses to various therapeutic interventions.
  
  
  METHODS
  Patients seen at the Duke University Hair Disorders Research and Treatment Center, Durham, NC, between 2004 and 2011 who met FFA inclusion criteria and signed an informed consent form for participation in the Duke University Hair Disorders Research and Treatment Center database were included in this review.
  
  
  RESULTS
  Nineteen female patients with FFA met our inclusion criteria, the majority of whom were white and postmenopausal. A number of treatments, including topical and intralesional steroids, antibiotics, and immunomodulators, were used with disappointing results in most patients. However, the majority of patients on dutasteride experienced disease stabilization.
  
  
  CONCLUSIONS
  This was a retrospective review and outside clinic records were occasionally incomplete.
  
  
  CONCLUSIONS
  FFA is an increasingly common form of scarring hair loss, but the origin remains unknown. Without clear understanding of the pathogenesis and evolution of this condition, it is not surprising that treatments to date have been minimally or not effective. At our institution, dutasteride was most effective in halting disease progression, although no therapy was associated with significant hair regrowth.
authors: Hair Disorders Research and Treatment Center, Duke University Medical Center, Durham, North Carolina, USA. barryladizinski@gmail.com
authors: Barry
authors: B
authors: Ladizinski
authors: Andrea
authors: A
authors: Bazakas
authors: M Angelica
authors: MA
authors: Selim
authors: Elise A
authors: EA
authors: Olsen
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000505:Alopecia / Q000188:drug therapy* / Q000473:pathology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001378:Azasteroids / Q000627:therapeutic use*; D002921:Cicatrix / Q000188:drug therapy / Q000473:pathology; D000068538:Dutasteride; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005138:Eyebrows / Q000473:pathology; D005260:Female; D005355:Fibrosis; D005546:Forehead / Q000098:blood supply / Q000473:pathology; D006785:Hospitals, University; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D007166:Immunosuppressive Agents; D008010:Lichen Planus / Q000188:drug therapy* / Q000473:pathology*; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use; D015663:Osteoporosis, Postmenopausal; D012189:Retrospective Studies; D012535:Scalp / Q000098:blood supply / Q000473:pathology; D016559:Tacrolimus / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D058891:5-alpha Reductase Inhibitors; D000900:Anti-Bacterial Agents; D001378:Azasteroids; D004791:Enzyme Inhibitors; D007166:Immunosuppressive Agents; D006886:Hydroxychloroquine; D008911:Minocycline; D000068538:Dutasteride; D016559:Tacrolimus; D008727:Methotrexate