Dermoscopic findings in frontal fibrosing alopecia: report of four cases

BACKGROUND: Frontal fibrosing alopecia (FFA) is characterized by frontotemporal hair recession and eyebrow loss and by a histopathology identical to lichen planopilaris. Differential diagnosis from other types of alopecia, including alopecia areata (AA), is necessary in some cases. OBJECTIVE: To describe dermoscopic findings of FFA and to investigate the possibility of utilizing dermoscopy as a diagnostic tool for FFA. METHODS: Four cases of FFA diagnosed by clinical and/or histological findings were examined by dermoscopy. RESULTS: The loss of orifices, perifollicular erythema or scale was seen in all the four cases (4/4), in three cases (3/4) or in two cases (2/4), respectively. None of the cases showed yellow dots characteristic of AA. Immunohistochemistry showed T lymphocyte infiltration into the infundibulum and isthmus. CONCLUSION: Dermoscopy is a helpful diagnostic tool for FFA especially to distinguish it from AA.