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.