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Kopera D, Cerroni L, Trüeb R. [Frontal hypopigmentation with band-like alopecia]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2022; 73:744-746. [PMID: 35347356 PMCID: PMC9427918 DOI: 10.1007/s00105-022-04976-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/21/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Daisy Kopera
- Klinik für Dermatologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8036, Graz, Österreich.
| | - Lorenzo Cerroni
- Klinik für Dermatologie, Medizinische Universität Graz, Auenbruggerplatz 8, 8036, Graz, Österreich
| | - Ralph Trüeb
- Haarcenter Wallisellen, Wallisellen, Schweiz
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Dutra Rezende H, Trüeb RM, Dias MFRG, Perez Bezerra de Lázaro B, Iglesias GA, Lopes Mattos Dinato S, Calaça Kabbach Prigenzi K. Pseudo‐Fringe
Sign in Frontal Fibrosing Alopecia‐like Cutaneous Lupus Erythematosus. J Eur Acad Dermatol Venereol 2022; 36:1871-1872. [DOI: 10.1111/jdv.18171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/05/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Ralph M. Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb, Zurich‐ Wallisellen Switzerland
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Kreuter A, Licciardi-Fernandez MJ, Burmann SN, Paschos A, Michalowitz AL. Baricitinib for recalcitrant subacute cutaneous lupus erythematosus with concomitant frontal fibrosing alopecia. Clin Exp Dermatol 2021; 47:787-788. [PMID: 34856011 DOI: 10.1111/ced.15044] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 11/29/2021] [Indexed: 11/28/2022]
Abstract
With great interest we read the recently published article by Joos et al.1 on the successful use of baricitinib for cutaneous lupus erythematosus (CLE). The authors present a heavily pre-treated case (including current systemic standard CLE medication such as hydroxychloroquine, topical and systemic corticosteroids) of subacute cutaneous lupus erythematosus (SCLE) that almost completely cleared (decline of CLASI score from 21 to 3) following 6 months of baricitinib therapy. We would like to add our experiences of baricitinib for SCLE in a patient with concomitant frontal fibrosing alopecia (FFA).
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Affiliation(s)
- A Kreuter
- Department of Dermatology, Venereology, and Allergology, HELIOS St. Elisabeth, Hospital Oberhausen, University Witten-Herdecke, Germany
| | - M J Licciardi-Fernandez
- Department of Dermatology, Venereology, and Allergology, HELIOS St. Elisabeth, Hospital Oberhausen, University Witten-Herdecke, Germany
| | - S-N Burmann
- Department of Dermatology, Venereology, and Allergology, HELIOS St. Elisabeth, Hospital Oberhausen, University Witten-Herdecke, Germany
| | - A Paschos
- Department of Dermatology, Venereology, and Allergology, HELIOS St. Elisabeth, Hospital Oberhausen, University Witten-Herdecke, Germany
| | - A-L Michalowitz
- Department of Dermatology, Venereology, and Allergology, HELIOS St. Elisabeth, Hospital Oberhausen, University Witten-Herdecke, Germany
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Trüeb RM, Gavazzoni MFR, Dutra Rezende H, Colli P. Comment on: Risk factors for frontal fibrosing alopecia: A case-control study in a multiracial population. J Am Acad Dermatol 2020; 84:e205-e206. [PMID: 33253842 DOI: 10.1016/j.jaad.2020.10.096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/24/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Ralph M Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb and University of Zurich, Switzerland.
| | - Maria Fernanda Reis Gavazzoni
- Department of Dermatology, Universidade Federal Fluminense, Centro de Ciências Médicas, Hospital Universitário Antonia Pedro, Niterói Rio de Janeiro, Brazil
| | - Hudson Dutra Rezende
- Department of Dermatology, Alvaro Alvim School Hospital, Campos dos Goytacazes, Rio de Janeiro, Brazil
| | - Pedro Colli
- Clínica Pedro Colli Dermatologia, Botucatu São Paulo, Brazil
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Frontal fibrosing alopecia: a disease that remains enigmatic. Postepy Dermatol Alergol 2020; 37:482-489. [PMID: 32994767 PMCID: PMC7507171 DOI: 10.5114/ada.2020.98241] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 11/27/2018] [Indexed: 12/19/2022] Open
Abstract
Frontal fibrosing alopecia (FFA) is recognized to represent a generalized process of inflammatory scarring alopecia. Apart from the classic form affecting the frontal hairline, there are a range of disease manifestations involving loss of eyebrows and of eyelashes, loss of peripheral body hair, fibrosing alopecia in a pattern distribution, facial and extrafacial skin, mucous membrane, and nail involvement. Classic linear, diffuse “zigzag”, pseudo “fringe sign”, androgenetic alopecia-like, cockade-like, ophiasis-like and incomplete patterns are distinguished. The aetiology of FFA remains obscure, but a number of pathogenetic hypotheses and treatments to halt disease progression have been proposed.
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Alopecia and techniques in hair restoration: an overview for the cosmetic surgeon. Oral Maxillofac Surg 2019; 23:123-131. [PMID: 30788753 DOI: 10.1007/s10006-019-00750-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/05/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE Alopecia is a debilitating disorder affecting millions of individuals worldwide. Although challenging to treat, advances in hair restoration technologies have led to multiple viable options with excellent clinical results. This paper seeks to provide an overview of hair loss and the currently utilized techniques in hair transplantation in order to serve as a reference source for the facial plastic surgeon. METHODS A comprehensive review of recent literature regarding the evaluation of, and management modalities for, alopecia was performed. RESULTS The follicular unit extraction technique and the strip harvest technique are both widely used for patients desiring transplantation. While both techniques can lead to successful outcomes, each has pros and cons that are important to understand prior to engaging in the procedure. CONCLUSION Advancements in hair restoration technologies implementing robotics, manual, or motorized follicular unit extraction have facilitated optimization of outcomes. Adjuvant treatment modalities including robotics and platelet-rich plasma injections have shown utility in augmenting transplantation.
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Abstract
Cutaneous and systemic lupus erythematosus (SLE) commonly involves the hair and scalp. Alopecia can result from direct activity of disease on the scalp or from the state of physical stress in the form of telogen effluvium. Discoid lupus erythematosus and lupus panniculitis/profundus are known to cause scarring alopecia, while accumulation of recent studies has shown that non-scarring alopecia in SLE may have different subtypes, comprising lupus erythematosus-specific and lupus erythematosus-nonspecific changes on histology. This review aims to summarize the clinical pattern, trichoscopic, histopathological, and direct immunofluorescence features of different types of alopecia in cutaneous and systemic lupus erythematosus, as well as exploring their relationship with SLE disease activity.
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Gavazzoni Dias MFR, Rezende HD, Lofeu Cury A, Trüeb RM, Vilar E. Hyperpigmented Upper Eyelid: A Clue to the Diagnosis of Facial Lichen Planus Pigmentosus in a Patient with Frontal Fibrosing Alopecia. Skin Appendage Disord 2018; 4:335-338. [PMID: 30410910 DOI: 10.1159/000487338] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 01/29/2018] [Indexed: 11/19/2022] Open
Abstract
Facial lichen planus pigmentosus (LPPig), a rare variant of classic lichen planus, was first described in patients with frontal fibrosing alopecia (FFA) by Dlova [Br J Dermatol 2013; 168: 439-442] in 2013. The diagnosis of facial LPPig is sometimes not easy, since clinical signs and histopathological features may frequently be confused with melasma or postinflammatory hyperpigmentation. We describe a case of a postmenopausal black woman diagnosed with FFA who presented with an identical brown-grayish pigmentation of the face and upper eyelids and typical dermoscopy analysis on both regions. We suggest that the hyperpigmentation of the upper eyelid with typical LLPig dermoscopy (upper eyelid sign) may be a clue for the diagnosis of LPPig and may avoid a scar-causing face biopsy.
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Affiliation(s)
| | - Hudson Dutra Rezende
- Faculdade de Medicina de Campos Hospital Escola Álvaro Alvim, Campos dos Goytacazes, Brazil
| | | | - Ralph M Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb and University of Zurich, Zurich, Switzerland
| | - Enoï Vilar
- Universidade Federal Fluminense, Niterói, Brazil
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Taguti P, Dutra H, Trüeb RM. Lichen Planopilaris Caused by Wig Attachment: A Case of Koebner Phenomenon in Frontal Fibrosing Alopecia. Int J Trichology 2018; 10:172-174. [PMID: 30386077 PMCID: PMC6192232 DOI: 10.4103/ijt.ijt_48_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Frontal fibrosing alopecia (FFA) represents a distinctive condition with a marginal scarring alopecia along the frontal and temporal hairline. Since its original description, the condition has been recognized to represent a more generalized than localized process, with extension beyond the frontotemporal hairline to include the parieto-occipital hairline and involve peculiar facial papules as evidence of facial vellus hair involvement and loss of peripheral body hair. Finally, the association of FFA with oral lichen planus, nail involvement, and concomitant lichen planopilaris (LPP) points to a close relationship to lichen planus. The Koebner phenomenon or isomorphic reaction has been described in lichen planus, LPP, and ultimately FFA, with face-lift procedures and hair restoration surgery having been implicated as the culprits in the latter. We report the first case of FFA in whom LPP developed at the sites of wig attachments, providing the evidence for Koebner phenomenon. Therefore, wigs are to be included to the list of procedures for hair restoration at risk of eliciting an isomorphic reaction in patients with FFA. Ultimately, the association of Koebner phenomenon with LPP-type lesions in FFA may provide further insight into the underlying pathology and nosology of the condition.
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Affiliation(s)
- Priscila Taguti
- Department of Dermatology, University Hospital of the North Parana, State University of Londrina, State University of Londrina, Parana, Brazil
| | - Hudson Dutra
- Center for Dermatology and Hair Diseases Professor Trüeb, Zurich-Wallisellen, Switzerland
| | - Ralph Michel Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb, Zurich-Wallisellen, Switzerland
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Abstract
Since its original report in 1994, frontal fibrosing alopecia has become increasingly common, attracting the attention of the medical community and giving rise to speculations on its etiology, specifically the possibility of environmental factors. Familial cases of frontal fibrosing alopecia point to the possible contribution of hereditary factors maybe related to androgenetic alopecia. We report thefirst case of connubial frontal fibrosing alopecia in a genetically unrelated couple pointing to the possibility of a common environmental exposure in the etiology of the condition. Our observation may be fortuitous, considering the high frequency of female frontal fibrosing alopecia. Nevertheless, the incidence of male frontal fibrosing alopecia has remained low with a consequently low statistical probability of random occurrence of the condition in a marital couple. We, therefore, suggest to systematically includes the hair condition of marital partners in the patient history of patients with frontal fibrosing alopecia, to elucidate the actual frequency of connubial frontal fibrosing alopecia and maybe a common causative agent or hair grooming practice.
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Affiliation(s)
- Ricardo da Silva Libório
- Department of Dermatology and Radiotherapy, Botucatu Medical School, Paulista State University, UNESP, São Paulo, Brazil
| | - Ralph M Trüeb
- Center for Dermatology and Hair Diseases Professor Trüeb, Zurich, Switzerland
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