title: Facial lesions in frontal fibrosing alopecia (FFA): Clinicopathological features in a series of 12 cases.
abstract: BACKGROUND
  Facial lesions in frontal fibrosing alopecia (FFA) have been poorly described in published series.
  
  
  OBJECTIVE
  We sought to describe facial lesions in FFA.
  
  
  METHODS
  We reviewed our series of 55 cases of FFA, selecting 12 cases with clinically significant facial lesions. We performed a histologic study of these lesions.
  
  
  RESULTS
  In addition to the observations already described in the literature such as facial papules or follicular red dots, we observed perifollicular and diffuse erythema, sometimes with a reticular pattern, and the gradual appearance of pigmented macules on facial skin. Biopsy specimens from the areas with facial erythema showed perifollicular and interfollicular lymphocytic infiltrate and fibrosis around vellus hair follicles. Histologic evaluation of pigmented macules sometimes exhibited an increased epidermal pigmentation and on occasions, pigmentary incontinence.
  
  
  CONCLUSIONS
  More patients are needed to determine the prevalence of these lesions in FFA.
  
  
  CONCLUSIONS
  On facial skin of patients with FFA, we can observe papules or perifollicular erythema secondary to vellus hair follicle involvement. We describe diffuse erythema, owing to follicular and interfollicular lichenoid infiltrate, and the gradual appearance of pigmented macules, which could be secondary to an increased epidermal pigmentation or to pigmentary incontinence.
authors.affiliation: Department of Dermatology, Hospital Universitario Donostia, San Sebastián, Spain. Electronic address: aranlop13@hotmail.es.
authors.forename: Arantxa
authors.initials: A
authors.lastname: López-Pestaña
authors.affiliation: Department of Dermatology, Hospital Universitario Donostia, San Sebastián, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Tuneu
authors.affiliation: Department of Pathology, Hospital Universitario Donostia, San Sebastián, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Lobo
authors.affiliation: Department of Dermatology, Hospital Universitario Donostia, San Sebastián, Spain.
authors.forename: Nerea
authors.initials: N
authors.lastname: Ormaechea
authors.affiliation: Department of Dermatology, Hospital Universitario Donostia, San Sebastián, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Zubizarreta
authors.affiliation: Department of Dermatology, Hospital Universitario Donostia, San Sebastián, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Vildosola
authors.affiliation: Department of Dermatology, Hospital Universitario Donostia, San Sebastián, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Del Alcazar
mesh_terms: D000328:Adult; D000367:Age Factors; D000505:Alopecia / Q000473:pathology* / Q000503:physiopathology; D001707:Biopsy, Needle; D018450:Disease Progression; D005148:Facial Dermatoses / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005355:Fibrosis / Q000473:pathology / Q000503:physiopathology; D018859:Hair Follicle / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008010:Lichen Planus / Q000473:pathology / Q000503:physiopathology; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology; D035583:Rare Diseases; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies
keywords: alopecia; face; frontal fibrosing alopecia; lichen planus; papules; vellus hair