title: Frontal fibrosing alopecia: a multicenter review of 355 patients.
abstract: BACKGROUND
  To our knowledge, there are no large multicenter studies concerning frontal fibrosing alopecia (FFA) that could give clues about its pathogenesis and best treatment.
  
  
  OBJECTIVE
  We sought to describe the epidemiology, comorbidities, clinical presentation, diagnostic findings, and therapeutic choices in a large series of patients with FFA.
  
  
  METHODS
  This retrospective multicenter study included patients given the diagnosis of FFA. Clinical severity was classified based on the recession of the frontotemporal hairline.
  
  
  RESULTS
  In all, 355 patients (343 women [49 premenopausal] and 12 men) with a mean age of 61 years (range 23-86) were included. Early menopause was detected in 49 patients (14%), whereas 46 (13%) had undergone hysterectomy. Severe FFA was observed in 131 patients (37%). Independent factors associated with severe FFA after multivariate analysis were: eyelash loss, facial papules, and body hair involvement. Eyebrow loss as the initial clinical presentation was associated with mild forms. Antiandrogens such as finasteride and dutasteride were used in 111 patients (31%), with improvement in 52 (47%) and stabilization in 59 (53%).
  
  
  CONCLUSIONS
  The retrospective design is a limitation.
  
  
  CONCLUSIONS
  Eyelash loss, facial papules, and body hair involvement were associated with severe FFA. Antiandrogens were the most useful treatment.
authors: Hospital Dermatology Service, Ramón y Cajal Hospital, IRYCIS, Universidad de Alcalá, Madrid, Spain. Electronic address: sergiovano@yahoo.es.
authors: Sergio
authors: S
authors: Vañó-Galván
authors: Hospital Dermatology Service, Fundación Jiménez Diaz, Madrid, Spain.
authors: Ana M
authors: AM
authors: Molina-Ruiz
authors: Hospital Dermatology Service, Guadix Hospital, Granada, Spain.
authors: Cristina
authors: C
authors: Serrano-Falcón
authors: Hospital Dermatology Service, Baza Hospital, Granada, Spain.
authors: Salvador
authors: S
authors: Arias-Santiago
authors: Hospital Dermatology Service, Grupo Pedro Jaén, Madrid, Spain.
authors: Ana R
authors: AR
authors: Rodrigues-Barata
authors: Hospital Dermatology Service, Reina Sofía Hospital, Córdoba, Spain.
authors: Gloria
authors: G
authors: Garnacho-Saucedo
authors: Hospital Dermatology Service, Manises Hospital, Valencia, Spain.
authors: Antonio
authors: A
authors: Martorell-Calatayud
authors: Hospital Dermatology Service, Alto Guadalquivir Hospital of Andújar (Jaén), Jaén, Spain.
authors: Pablo
authors: P
authors: Fernández-Crehuet
authors: Hospital Dermatology Service, Universitat de Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain.
authors: Ramón
authors: R
authors: Grimalt
authors: Hospital Dermatology Service, Clínica Universitaria de Navarra, Madrid, Spain.
authors: Beatriz
authors: B
authors: Aranegui
authors: Hospital Dermatology Service, Ramón y Cajal Hospital, IRYCIS, Universidad de Alcalá, Madrid, Spain.
authors: Emiliano
authors: E
authors: Grillo
authors: Hospital Dermatology Service, Ramón y Cajal Hospital, IRYCIS, Universidad de Alcalá, Madrid, Spain.
authors: Blanca
authors: B
authors: Diaz-Ley
authors: Hospital Dermatology Service, Reina Sofía Hospital, Córdoba, Spain.
authors: Rafael
authors: R
authors: Salido
authors: Hospital Dermatology Service, Ramón y Cajal Hospital, IRYCIS, Universidad de Alcalá, Madrid, Spain.
authors: Sivia
authors: S
authors: Pérez-Gala
authors: Hospital Dermatology Service, Universidad de Granada, Granada, Spain.
authors: Salvio
authors: S
authors: Serrano
authors: Hospital Dermatology Service, Reina Sofía Hospital, Córdoba, Spain.
authors: Jose Carlos
authors: JC
authors: Moreno
authors: Hospital Dermatology Service, Ramón y Cajal Hospital, IRYCIS, Universidad de Alcalá, Madrid, Spain.
authors: Pedro
authors: P
authors: Jaén
authors: Hospital Dermatology Service, Virgen Macarena Hospital, Sevilla, Spain.
authors: Francisco M
authors: FM
authors: Camacho
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000505:Alopecia / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D001378:Azasteroids / Q000627:therapeutic use*; D001707:Biopsy, Needle; D015331:Cohort Studies; D000068538:Dutasteride; D005260:Female; D005355:Fibrosis / Q000453:epidemiology / Q000473:pathology; D018120:Finasteride / Q000627:therapeutic use*; D005546:Forehead; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017698:Postmenopause / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001378:Azasteroids; D018120:Finasteride; D000068538:Dutasteride
keywords: alopecia; dutasteride; finasteride; frontal fibrosing alopecia; hair; hair loss; lichen planopilaris; scarring; trichology