Frontal fibrosing alopecia and lichen planus pigmentosus: a case series
DOI:
https://doi.org/10.29176/2590843X.1522Palabras clave:
Alopecia, Lichen planus, Facial papules, Physiopathology, DiagnosisResumen
Frontal fibrosing alopecia is a type of scarring alopecia that has been associated with different skin lesions including lichen planus pigmentosus. Both diseases share common pathophysiological mechanisms, which explain their coexistence in the same patient. We report 12 cases of mestizo women with frontal fibrosing alopecia and lichen planus pigmentosus confirmed by histopathology and discuss the pathophysiological mechanisms shared by both diseases. The most important pathophysiological mechanism common to both diseases is the cytotoxic T-lymphocyte response, which is directed against keratinocytes and hair follicle stem cells, causing apoptosis and damage to the basal layer, with consequent tissue remodeling that determines the clinical appearance of the lesions of frontal fibrosing alopecia and lichen planus pigmentosus.
Biografía del autor/a
Diana Marcela Méndez
Dermatólogo, Hospital Universitario Centro Dermatológico Federico Lleras Acosta, E.S.E. Bogotá D.C., Colombia.
ORCID https://orcid.org/0000-0002-6834-1157
Claudia Marcela Arenas
Dermatólogo, Hospital Universitario Centro Dermatológico Federico Lleras Acosta, E.S.E. Bogotá D.C., Colombia.
ORCID https://orcid.org/0000-0003-3689-5355
Camilo Andrés Morales
Dermatólogo, Hospital Universitario Centro Dermatológico Federico Lleras Acosta, E.S.E. Bogotá D.C., Colombia. Docente adjunto, Fundación Universitaria Sanitas, Bogotá, D.C., Colombia. ORCID https://orcid.org/0000-0002-3187-3272
Referencias bibliográficas
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5. Dlova NC. Frontal fibrosing alopecia and li¬chen planus pigmentosus: Is there a link? Br J Dermatol. 2013;168(2):439-42. doi: 10.1111/j.1365-2133.2012.11146.x
6. Berliner J, McCalmont T, Price V, Berger T. Frontal fibrosing alopecia and lichen planus pigmen¬tosus. J Am Acad Dermatol. 2014;71(1):e26-7. doi: 10.1016/j.jaad.2013.12.031
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9. Romiti R, Fátima C, Gavioli B, Anzai A, Munck A, Oliveira C, Valente NYS. Clinical and histo¬pathological findings of frontal fibrosing alo¬pecia-associated lichen planus pigmentosus. Skin Appendage Disord. 2017;3(2):59-63. doi: 10.1159/000456038
10. Buthani LK, Bedi TR, Pandhi RK, Nayak NC. Lichen planus pigmentosus. Dermatologica. 1974;149:43-50.
11. Gómez B, Salazar C, López S, Romano S, Lórenz M. [Lichen planus pigmentosus: a case report and literature review]. Arch Argent Dermatol. 2012;62:102-5.
12. Kanwar AJ, Dogra S, Handa S, Parsad D, Radotra BD. A study of 124 Indian pa¬tients with lichen planus pigmentosus. Clin Exp Dermatol. 2003;28(5):481-5. doi: 10.1046/j.1365-2230.2003.01367.x
13. Sindhura KBN, Vinay K, Kumaran MS, Saikia UN, Parsad D. Lichen planus pigmentosus: A retrospective clinico-epidemiologic study with emphasis on the rare follicular variant. J Eur Acad Dermatol Venereol. 2016;30(11):e142-e144. doi: 10.1111/jdv.13454
14. Kossard S, Lee M, Wilkinson B. Postme¬nopausal frontal fibrosing alopecia: A frontal variant of lichen planopilaris. J Am Acad Dermatol. 1997;36(1):59-66. doi: 10.1016/s0190-9622(97)70326-8
15. Samrao A, Chew AL, Price V. Frontal fibrosing alopecia: A clinical review of 36 patients. Br J Der¬matol. 2010;163(6):1296-300. doi: 10.1111/j.1365-2133.2010.09965.x
16. Faulkner C, Wilson N, Jones S. Frontal fibro¬sing alopecia associated with cutaneous li¬chen planus in a premenopausal woman. Australas J Dermatol. 2002;43(1):65-7. doi: 10.1046/j.1440-0960.2002.00558.x
17. Abbas O, Chedraoui A, Ghosn S. Frontal fibro¬sing alopecia presenting with components of Piccardi-Lassueur-Graham-Little syndrome. J Am Acad Dermatol. 2007;57(2 Suppl):15-8. doi: 10.1016/j.jaad.2006.11.010
18. Tan KT, Messenger AG. Frontal fibrosing alopecia: clinical presentations and prog¬nosis. Br J Dermatol. 2009;160(1):75-9. doi: 10.1111/j.1365-2133.2008.08861.x
19. Tziotzios C, Stefanato CM, Fenton DA, Simpson MA, McGrath JA. Frontal fibrosing alopecia: re¬flections and hypotheses on etiology and patho¬genesis. Exp Dermatol. 2016;25(11):847-52. doi: 10.1111/exd.13071
20. López-Pestaña A, Tuneu A, Lobo C, Ormaechea N, Zubizarreta J, Vildosola S, Del Alcazar E. Facial lesions in frontal fibrosing alopecia (FFA): Cli¬nicopathological features in a series of 12 cases. J Am Acad Dermatol. 2015;73(6):987.e1-e6. doi: 10.1016/j.jaad.2015.08.020
21. Pirmez R, Donati A, Valente NS, Sodre CT, Tosti A. Glabellar red dots in frontal fibrosing alo¬pecia: A further clinical sign of vellus follicle in¬volvement. Br J Dermatol. 2014;170(3):745-6. doi: 10.1111/bjd.12683
22. Mervis JS, Borda LJ, Miteva M. Facial and extrafa¬cial lesions in an ethnically diverse series of 91 pa¬tients with frontal fibrosing alopecia followed at a single center. Dermatology. 2019;235(2):112-9. doi: 10.1159/000494603
23. Moreno-Ramírez D, Ferrándiz L, Ca¬macho FM. Diagnostic and therapeutic as¬sessment of frontal fibrosing alopecia. Actas Dermosifiliogr. 2007;98(9):594-602. doi: 10.1016/S1578-2190(07)70524-3
24. Rieder E, Kaplan J, Kamino H, Sanchez M, Pome¬ranz MK. Lichen planus pigmentosus. Dermatol Online J. 2013;19(12):20713.
25. Gupta S, Jawanda MK. Oral lichen planus: an update on etiology, pathogenesis, cli¬nical presentation, diagnosis and manage-ment. Indian J Dermatol. 2015;60(3):222-9. doi: 10.4103/0019-5154.156315
26. Roopashree MR, Gondhalekar RV, Shashikanth MC, George J, Thippeswamy SH, Shukla A. Pathogenesis of oral lichen planus -- a review. J Oral Pathol Med. 2010;39(10):729-34. doi: 10.1111/j.1600-0714.2010.00946.x
27. Di Lernia V. Targeting the IFN- c / CXCL10 pathway in lichen planus. Med Hipotheses. 2016;92:60-1.
28. Sontheimer RD. Lichenoid tissue reaction/inter¬face dermatitis: clinical and histological perspec¬tives. J Invest Dermatol. 2009;129(5):1088-99. doi: 10.1038/sj.jid.2009.42
29. Harries MJ, Paus R. The pathoge¬nesis of primary cicatricial alopecias. Am J Pathol. 2010;177(5):2152-62. doi: 10.2353/ajpath.2010.100454
30. Sehgal VN, Srivastava G, Sharma S, Sehgal S, Verma P. Lichenoid tissue reaction/interface dermatitis: clinicopathological overtones. Indian J Derma¬tology Venereol Leprol. 2011;77(4):418-29. doi: 10.4103/0378-6323.82389
31. Harries MJ, Meyer K, Chaudhry I, Kloepper JE, Poblet E, Griffiths CE, Paus R. Lichen plano¬pilaris is characterized by immune privilege collapse of the hair follicle’s epithelial stem cell niche. J Pathol. 2013;231(2):236-47. doi: 10.1002/path.4233
32. Rácz E, Gho C, Moorman PW, Noordhoek V, Neu¬mann H. Treatment of frontal fibrosing alopecia and lichen planopilaris: A systematic review. J Eur Acad Dermatol Venereol. 2013;27(12):1461-70. doi: 10.1111/jdv.12139
2. Chew A, Bashir S, Wain E, Fenton D, Stefa¬nato C. Expanding the spectrum of frontal fibrosing alopecia: A unifying concept. J Am Acad Dermatol. 2010;63(4):653-60. doi: 10.1016/j.jaad.2009.09.020
3. Moreno-Ramírez D, Camacho F. Frontal fibro¬sing alopecia: a survey in 16 patients. J Eur Acad Dermatol Venereol. 2005;19(6):700-5. doi: 10.1111/j.1468-3083.2005.01291.x
4. Tosti A, Piraccini BM, Iorizzo M, Misciali C. Frontal fibrosing alopecia in postmenopausal women. J Am Acad Dermatol. 2005;52(1):55-60. doi: 10.1016/j.jaad.2004.05.014
5. Dlova NC. Frontal fibrosing alopecia and li¬chen planus pigmentosus: Is there a link? Br J Dermatol. 2013;168(2):439-42. doi: 10.1111/j.1365-2133.2012.11146.x
6. Berliner J, McCalmont T, Price V, Berger T. Frontal fibrosing alopecia and lichen planus pigmen¬tosus. J Am Acad Dermatol. 2014;71(1):e26-7. doi: 10.1016/j.jaad.2013.12.031
7. Rao R, Sarda A, Khanna R, Balachan¬dran C. Coexistence of frontal fibrosing alopecia with lichen planus pigmen¬tosus. Int J Dermatol. 2014;53(5):622-4. doi: 10.1111/j.1365-4632.2012.05630.x
8. Pirmez R, Duque-Estrada B, Donati A, Campos-do-Carmo G, Valente NS, Romiti R, Sodré CT, Tosti A. Clinical and dermoscopic features of lichen planus pigmentosus in 37 patients with frontal fibrosing alopecia. Br J Dermatol. 2016;175(6):1387-1390. doi: 10.1111/bjd.14722
9. Romiti R, Fátima C, Gavioli B, Anzai A, Munck A, Oliveira C, Valente NYS. Clinical and histo¬pathological findings of frontal fibrosing alo¬pecia-associated lichen planus pigmentosus. Skin Appendage Disord. 2017;3(2):59-63. doi: 10.1159/000456038
10. Buthani LK, Bedi TR, Pandhi RK, Nayak NC. Lichen planus pigmentosus. Dermatologica. 1974;149:43-50.
11. Gómez B, Salazar C, López S, Romano S, Lórenz M. [Lichen planus pigmentosus: a case report and literature review]. Arch Argent Dermatol. 2012;62:102-5.
12. Kanwar AJ, Dogra S, Handa S, Parsad D, Radotra BD. A study of 124 Indian pa¬tients with lichen planus pigmentosus. Clin Exp Dermatol. 2003;28(5):481-5. doi: 10.1046/j.1365-2230.2003.01367.x
13. Sindhura KBN, Vinay K, Kumaran MS, Saikia UN, Parsad D. Lichen planus pigmentosus: A retrospective clinico-epidemiologic study with emphasis on the rare follicular variant. J Eur Acad Dermatol Venereol. 2016;30(11):e142-e144. doi: 10.1111/jdv.13454
14. Kossard S, Lee M, Wilkinson B. Postme¬nopausal frontal fibrosing alopecia: A frontal variant of lichen planopilaris. J Am Acad Dermatol. 1997;36(1):59-66. doi: 10.1016/s0190-9622(97)70326-8
15. Samrao A, Chew AL, Price V. Frontal fibrosing alopecia: A clinical review of 36 patients. Br J Der¬matol. 2010;163(6):1296-300. doi: 10.1111/j.1365-2133.2010.09965.x
16. Faulkner C, Wilson N, Jones S. Frontal fibro¬sing alopecia associated with cutaneous li¬chen planus in a premenopausal woman. Australas J Dermatol. 2002;43(1):65-7. doi: 10.1046/j.1440-0960.2002.00558.x
17. Abbas O, Chedraoui A, Ghosn S. Frontal fibro¬sing alopecia presenting with components of Piccardi-Lassueur-Graham-Little syndrome. J Am Acad Dermatol. 2007;57(2 Suppl):15-8. doi: 10.1016/j.jaad.2006.11.010
18. Tan KT, Messenger AG. Frontal fibrosing alopecia: clinical presentations and prog¬nosis. Br J Dermatol. 2009;160(1):75-9. doi: 10.1111/j.1365-2133.2008.08861.x
19. Tziotzios C, Stefanato CM, Fenton DA, Simpson MA, McGrath JA. Frontal fibrosing alopecia: re¬flections and hypotheses on etiology and patho¬genesis. Exp Dermatol. 2016;25(11):847-52. doi: 10.1111/exd.13071
20. López-Pestaña A, Tuneu A, Lobo C, Ormaechea N, Zubizarreta J, Vildosola S, Del Alcazar E. Facial lesions in frontal fibrosing alopecia (FFA): Cli¬nicopathological features in a series of 12 cases. J Am Acad Dermatol. 2015;73(6):987.e1-e6. doi: 10.1016/j.jaad.2015.08.020
21. Pirmez R, Donati A, Valente NS, Sodre CT, Tosti A. Glabellar red dots in frontal fibrosing alo¬pecia: A further clinical sign of vellus follicle in¬volvement. Br J Dermatol. 2014;170(3):745-6. doi: 10.1111/bjd.12683
22. Mervis JS, Borda LJ, Miteva M. Facial and extrafa¬cial lesions in an ethnically diverse series of 91 pa¬tients with frontal fibrosing alopecia followed at a single center. Dermatology. 2019;235(2):112-9. doi: 10.1159/000494603
23. Moreno-Ramírez D, Ferrándiz L, Ca¬macho FM. Diagnostic and therapeutic as¬sessment of frontal fibrosing alopecia. Actas Dermosifiliogr. 2007;98(9):594-602. doi: 10.1016/S1578-2190(07)70524-3
24. Rieder E, Kaplan J, Kamino H, Sanchez M, Pome¬ranz MK. Lichen planus pigmentosus. Dermatol Online J. 2013;19(12):20713.
25. Gupta S, Jawanda MK. Oral lichen planus: an update on etiology, pathogenesis, cli¬nical presentation, diagnosis and manage-ment. Indian J Dermatol. 2015;60(3):222-9. doi: 10.4103/0019-5154.156315
26. Roopashree MR, Gondhalekar RV, Shashikanth MC, George J, Thippeswamy SH, Shukla A. Pathogenesis of oral lichen planus -- a review. J Oral Pathol Med. 2010;39(10):729-34. doi: 10.1111/j.1600-0714.2010.00946.x
27. Di Lernia V. Targeting the IFN- c / CXCL10 pathway in lichen planus. Med Hipotheses. 2016;92:60-1.
28. Sontheimer RD. Lichenoid tissue reaction/inter¬face dermatitis: clinical and histological perspec¬tives. J Invest Dermatol. 2009;129(5):1088-99. doi: 10.1038/sj.jid.2009.42
29. Harries MJ, Paus R. The pathoge¬nesis of primary cicatricial alopecias. Am J Pathol. 2010;177(5):2152-62. doi: 10.2353/ajpath.2010.100454
30. Sehgal VN, Srivastava G, Sharma S, Sehgal S, Verma P. Lichenoid tissue reaction/interface dermatitis: clinicopathological overtones. Indian J Derma¬tology Venereol Leprol. 2011;77(4):418-29. doi: 10.4103/0378-6323.82389
31. Harries MJ, Meyer K, Chaudhry I, Kloepper JE, Poblet E, Griffiths CE, Paus R. Lichen plano¬pilaris is characterized by immune privilege collapse of the hair follicle’s epithelial stem cell niche. J Pathol. 2013;231(2):236-47. doi: 10.1002/path.4233
32. Rácz E, Gho C, Moorman PW, Noordhoek V, Neu¬mann H. Treatment of frontal fibrosing alopecia and lichen planopilaris: A systematic review. J Eur Acad Dermatol Venereol. 2013;27(12):1461-70. doi: 10.1111/jdv.12139
Cómo citar
1.
Méndez DM, Arenas CM, Morales CA. Frontal fibrosing alopecia and lichen planus pigmentosus: a case series. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 19 de octubre de 2020 [citado 20 de abril de 2024];28(2):176-83. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/1522
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2020-10-19
Cómo citar
1.
Méndez DM, Arenas CM, Morales CA. Frontal fibrosing alopecia and lichen planus pigmentosus: a case series. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 19 de octubre de 2020 [citado 20 de abril de 2024];28(2):176-83. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/1522
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