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Frontal Fibrosing Alopecia — SCE Dermatology MCQ

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HardHair DisordersFrontal Fibrosing AlopeciaSCE Dermatology

A 14-year-old girl presents with a 6-month history of progressive hair loss affecting her frontotemporal hairline with loss of eyebrows. Trichoscopy shows perifollicular scaling and erythema. Biopsy shows lichenoid interface dermatitis with fibrosis around hair follicles. What is the most likely diagnosis?

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Correct answer: C — Frontal fibrosing alopecia

Frontal fibrosing alopecia (FFA) is a form of lichen planopilaris characterised by progressive recession of the frontotemporal hairline with perifollicular erythema and scaling. Loss of eyebrows and eyelashes is common. Although classically a disease of postmenopausal women, it is increasingly reported in younger women and rarely in men. Biopsy shows lichenoid lymphocytic infiltrate around the isthmus and infundibulum with perifollicular fibrosis (cicatricial alopecia). Traction alopecia affects the same region but lacks the inflammatory/fibrotic histology.

Reference: BAD 2021 Patient Information on Frontal Fibrosing Alopecia