Turkiye Klinikleri Journal of Dermatology

.: ORIGINAL RESEARCH
Evaluation of the Demographic Characteristics and the Factors Related to Eyebrow Involvement in Frontal Fibrosing Alopecia: A Retrospective, Cross-sectional, Single Center Study
Frontal Fibrozan Alopesili Hastalarda Demografik Bulguların ve Kaş Tutulumunu Etkileyen Faktörlerin Değerlendirilmesi: Geri Dönük, Kesitsel, Tek Merkezli Çalışma
Tuğba Kevser UZUNÇAKMAKa, Defne ÖZKOCAa, Özge AŞKINa, Server SERDAROĞLUa
aDepartment of Dermatology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, TURKEY
Turkiye Klinikleri J Dermatol. 2021;31(2):93-9
doi: 10.5336/dermato.2021-81322
Article Language: EN
Full Text
ABSTRACT
 Objective: Frontal fibrosing alopecia (FFA) is a rare subtype of primary cicatricial alopecia leading to the gradual recession of the frontotemporal hairline. Eyebrow and facial hair alopecia commonly accompany the scalp hair loss. The usual FFA patient is a postmenopausal female. The most common comorbid diseases in FFA patients are thyroid diseases. In this retrospective, cross sectional study, we aimed to determine the demographic characteristics of the patients with FFA, prevelance of eyebrow involvement and the factors that are associated with eyebrow involvement at the time of evaluation. Material and Methods: A total of 16 patients who were diagnosed with FFA at our department from January 2010 to January 2020 were enrolled in this study. Demographic features and histopathological data were collected from medical records in our Hair Disorders Policlinic .The statistical analysis was performed with the SPSS-21. Results: A total of 16 patients were included in this study. All of the patients were females. Eyebrow loss was observed in 12 (75%) of our patients. The age of the patients had no statistically significant relationship to the eyebrow involvement (p=0.666). Likewise, there is no statistically significant relationship of disease duration to eyebrow involvement (p=0.668). Eyebrow involvement was also more common (75%) in patients who have comorbidity. Conclusion: Similar to the literature, FFA was found to be more common in postmenopausal female patients in our study. There was no statistically significant relationship between eyebrow loss and the duration of the disease or the age of the patient, but it was striking that the frequency of eyebrow involvement was more common in patients with comorbidities. These data obtained from our study have not been reported in the literature before, and larger patient series are needed to explain the relationship more clearly.

Keywords: Frontal fibrosing alopecia; eyebrows; comorbidity; cicatricial alopecia; age
ÖZET
 Amaç: Frontal fibrozan alopesi (FFA), nadir görülen, frontotemporal saç çizgisinde progresif geriye doğru saç kaybı ile karakterize bir primer skatrisyel alopesi alt tipidir. Hastalarda, saçlı derideki kayıpların yanı sıra sıklıkla kaş tutulumu ve yüz kıllarında da kayıp izlenmektedir. En sık postmenopozal kadın hastalarda görülür ve en sık eşlik eden hastalık tiroid bezi hastalıkları olarak bildirilmiştir. Bu retrospektif, kesitsel çalışmada, kliniğimize başvuran klinik ve histopatolojik bulguları ile FFA tanısı alan hastaların demografik bulgularının, kaş tutulumu sıklığının ve kaş tutulumunu etkileyebilecek faktörlerin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmaya, Ocak 2010 ve Ocak 2020 tarihleri arasında hastanemizde FFA tanısı alan 16 hasta dâhil edilmiştir. Hastalara ait demografik özellikler ve histopatolojik veriler kliniğimiz saç hastalıkları polikliniği takip dosyalarından retrospektif olarak taranmıştır. İstatistiksel analiz SPSS-21 ile yapılmıştır. Bulgular: Bu çalışmaya katılan 16 hastanın, hepsi kadın idi. Kaş tutulumu, hastaların 12'sinde (%75) mevcuttu. Hastaların yaşı ile kaş tutulumu arasında istatistiksel olarak anlamlı fark bulunmadı (p=0,666). Benzer şekilde, hastalık süresi ile kaş tutulumu arasında da anlamlı fark izlenmedi (p=0,668). Kaş tutulumu sıklığının komorbiditesi olan hastalarda daha sık olduğu izlendi (%75). Sonuç: Çalışmamızda, literatürle benzer şekilde FFA'nın postmenopozal kadın hastalarda daha sık olduğu görüldü. Kaş dökülmesi ile hastalık süresi veya hastanın yaşı arasında istatistiksel olarak önemli bir ilişki bulunamamıştır ancak kaş tutulumu sıklığının komorbiditesi olan hastalarda daha sık görülmesi dikkat çekiciydi. Çalışmamızdan elde ettiğimiz bu veriler, literatürde daha önce bildirilmemiş olup, aradaki ilişkinin daha net açıklanabilmesi için daha geniş hasta serilerine ihtiyaç duyulmaktadır.

Anahtar Kelimeler: Frontal fibrozan alopesi; kaşlar; komorbidite; skatrisyel alopesi; yaş
REFERENCES:
  1. Moreno-Arrones OM, Saceda-Corralo D, Fonda-Pascual P, Rodrigues-Barata AR, Buendía-Casta-o D, Alegre-Sánchez A, et al. Frontal fibrosing alopecia: clinical and prognostic classification. J Eur Acad Dermatol Venereol. 2017;31(10):1739-45. [Crossref]  [PubMed] 
  2. Mirmirani P, Tosti A, Goldberg L, Whiting D, Sotoodian B. Frontal fibrosing alopecia: an emerging epidemic. Skin Appendage Disord. 2019;5(2):90-3. [Crossref]  [PubMed]  [PMC] 
  3. Kanti V, Constantinou A, Reygagne P, Vogt A, Kottner J, Blume-Peytavi U. Frontal fibrosing alopecia: demographic and clinical characteristics of 490 cases. J Eur Acad Dermatol Venereol. 2019;33(10):1976-83. [Crossref]  [PubMed] 
  4. Fertig R, Tosti A. Frontal fibrosing alopecia treatment options. Intractable Rare Dis Res. 2016;5(4):314-5. [Crossref]  [PubMed]  [PMC] 
  5. Secchin P, Quintella DC, Paula NÁO, Andrade LCDS, Sodré CT. Clinical-histopathological profile of the frontal fibrosing alopecia: a retrospective study of 16 cases of a university hospital. An Bras Dermatol. 2019;94(4):416-21. [Crossref]  [PubMed]  [PMC] 
  6. Zhang M, Zhang L, Rosman IS, Mann CM. Frontal fibrosing alopecia demographics: a survey of 29 patients. Cutis. 2019;103(2):E16-E22. [PubMed] 
  7. Maldonado Cid P, Leis Dosil VM, Garrido Gutiérrez C, Salinas Moreno S, Thuissard Vasallo IJ, Andreu Vázquez C, et al. Frontal fibrosing alopecia: a retrospective study of 75 patients. Actas Dermosifiliogr. 2020;111(6): 487-95. [Crossref]  [PubMed] 
  8. Peterson E, Gutierrez D, Brinster NK, Lo Sicco KI, Shapiro J. Frontal fibrosing alopecia in males: demographics, clinical profile and treatment experience. J Eur Acad Dermatol Venereol. 2020;34(2):e101-e4. [Crossref]  [PubMed] 
  9. Nasiri S, Dadkhahfar S, Mansouri P, Rahmani-Khah E, Mozafari N. Evaluation of serum level of sex hormones in women with frontal fibrosing alopecia in comparison to healthy controls. Dermatol Ther. 2020;33(6):e13842. [Crossref]  [PubMed] 
  10. Starace M, Brandi N, Alessandrini A, Bruni F, Piraccini BM. Frontal fibrosing alopecia: a case series of 65 patients seen in a single Italian centre. J Eur Acad Dermatol Venereol. 2019;33(2):433-8. [Crossref]  [PubMed] 
  11. Takahashi TA, Johnson KM. Menopause. Med Clin North Am. 2015;99(3):521-34. [Crossref]  [PubMed] 
  12. Chew AL, Bashir SJ, Wain EM, Fenton DA, Stefanato CM. Expanding the spectrum of frontal fibrosing alopecia: a unifying concept. J Am Acad Dermatol. 2010;63(4):653-60. [Crossref]  [PubMed] 
  13. Katoulis AC, Damaskou V, Diamanti K, Pouliakis A, Mortaki D, Zacharatou A, et al. Eyebrow involvement in frontal fibrosing alopecia: a clinicopathologic cohort study for the reversibility of hair loss. J Am Acad Dermatol. 2020;82(3):755-7. [Crossref]  [PubMed] 
  14. Valesky EM, Maier MD, Kaufmann R, Zöller N, Meissner M. Single-center analysis of patients with frontal fibrosing alopecia: evidence for hypothyroidism and a good quality of life. J Int Med Res. 2019;47(2):653-61. [Crossref]  [PubMed]  [PMC] 
  15. MacDonald A, Clark C, Holmes S. Frontal fibrosing alopecia: a review of 60 cases. J Am Acad Dermatol. 2012;67(5):955-61. [Crossref]  [PubMed] 
  16. Garcia-Robledo JE, Aragón CC, Nieto-Aristizábal I, Vásquez S, Montoya C, Tobón GJ. Frontal fibrosing alopecia: A new autoimmune entity? Med Hypotheses. 2019;124:13-6. [Crossref]  [PubMed] 
  17. Ho A, Shapiro J. Medical therapy for frontal fibrosing alopecia: a review and clinical approach. J Am Acad Dermatol. 2019;81(2):568-80. [Crossref]  [PubMed] 
  18. Samrao A, Chew AL, Price V. Frontal fibrosing alopecia: a clinical review of 36 patients. Br J Dermatol. 2010;163(6):1296-300. [Crossref]  [PubMed] 
  19. Banka N, Mubki T, Bunagan MJ, McElwee K, Shapiro J. Frontal fibrosing alopecia: a retrospective clinical review of 62 patients with treatment outcome and long-term follow-up. Int J Dermatol. 2014;53(11):1324-30. [Crossref]  [PubMed] 
  20. Va-ó-Galván S, Molina-Ruiz AM, Serrano-Falcón C, Arias-Santiago S, Rodrigues-Barata AR, Garnacho-Saucedo G, et al. Frontal fibrosing alopecia: a multicenter review of 355 patients. J Am Acad Dermatol. 2014;70(4): 670-8. [Crossref]  [PubMed] 

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