Frontal Fibrosing Alopecia in Women: The Mayo Clinic Experience With 148 Patients, 1992-2016
Frontal Fibrosing Alopecia in Women: The Mayo Clinic Experience With 148 Patients, 1992-2016
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DOI：
10.1016/j.mayocp.2018.05.036
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发表时间：
2018-11-01
影响因子：
8.9
通讯作者：
Tolkachjov, Stanislav N.
中科院分区：
文献类型：
--
作者：
Imhof, Reese L.;Chaudhry, Hafsa M.;Tolkachjov, Stanislav N.
目的：探讨女性额部纤维化性脱发的临床病理表现、合并症和治疗结果。患者和方法：回顾性分析1992年1月1日至2016年2月22日梅奥诊所的女性额部纤维化性脱发患者。“瘢痕性脱发”、“地衣”、“扁平秃”、“纤维化”和“脱发”等术语被用于搜索年龄在1至100岁之间的女性患者。对686例患者进行回顾性分析，以确定额部纤维化性脱发的诊断。符合诊断标准的患者被纳入。结果：共发现148例女性额部纤维化性脱发，平均年龄62岁；60.1%出现眉损；67.6%和27.7%分别描述了之前或同时出现的瘙痒和头痛症；44.6%有甲状腺功能减退病史；13%有手术停经史；63.3%有激素替代治疗史。共有18.2%的患者在其他身体部位出现扁平苔藓，26.3%的患者病情稳定，通常需要联合治疗。平均缓解时间为1.8年。结论：额部纤维化性脱发患者通常伴有额颞部和眉部脱发。甲状腺功能减退和子宫切除术史可能比以前报道的更常见。从表现、诊断到稳定通常需要几个月到几年的时间。缺乏治疗反应的患者可能出现眉毛脱落、睫毛脱落和面部丘疹。联合治疗有助于减缓疾病进展或稳定疾病，尽管复发是常见的。需要对治疗和疗效进行进一步的研究。本研究的局限性包括回顾性设计和不同的随访。(C) 2018年梅奥医学教育与研究基金会
Objective: To characterize the clinicopathologic findings, comorbidities, and treatment outcomes of women with frontal fibrosing alopecia.Patients and Methods: Retrospective review of women with frontal fibrosing alopecia at Mayo Clinic from January 1, 1992, to February 22, 2016. The terms "scarring alopecia," "lichen," "planopilaris," "fibrosing,"and "alopecia" were used for the search of female patients aged 1 to 100 years. A total of 686 patients were reviewed to confirm the diagnosis of frontal fibrosing alopecia. Patients were included if they met diagnostic criteria.Results: A total of 148 women with frontal fibrosing alopecia were identified, with a mean age of 62 years; 60.1% presented with eyebrow loss; 67.6% and 27.7% described preceding or concurrent pruritus and trichodynia, respectively; 44.6% had a history of hypothyroidism; 13% had a history of surgical menopause; and 63.3% had a history of hormone replacement therapy. A total of 18.2% had lichen planus at other body sites, and 26.3% achieved disease stabilization, often requiring combination therapies. The mean time to remission was 1.8 years.Conclusion: Patients with frontal fibrosing alopecia typically present with frontotemporal and eyebrow alopecia with preceding symptoms. Hypothyroidism and a history of hysterectomy may be more common than previously reported. Time to presentation, diagnosis, and stabilization is often months to years. Patients who lack treatment response may present with eyebrow loss, eyelash loss, and facial papules. Combination therapy is helpful in achieving slowing of disease progression or disease stabilization, although recurrence is common. Additional studies on treatment and efficacy are needed. Limitations to this study include the retrospective design and varied follow-up. (C) 2018 Mayo Foundation for Medical Education and Research