medigraphic.com
Órgano oficial de la Sociedad Mexicana de Cirugía Dermatológica y Oncológica, AC

2021, Number 2

<< Back Next >>

Dermatología Cosmética, Médica y Quirúrgica 2021; 19 (2)

Facial Papules on Five Women with Frontal Fibrosing Alopecia Treated with Oral Isotretionine

Morales CCA, Sánchez L, Méndez VDM

Language: Spanish
References: 28
Page: 132-137
PDF size: 205.02 Kb.


ABSTRACT

Facial papules are considered a cutaneous manifestation of frontal fibrosing alopecia especially in premenopausal women with higher skin phototypes. Although the precise etiology is unknown, it has been suggested that there is a structural alteration of the sebaceous gland, which justifies oral isotretinoin treatment.
We present five cases of premenopausal Colombian mestizo women with frontal fibrosing alopecia, eyebrow alopecia, lichen planus pigmentosum, and facial papules, in whom oral isotretinoin treatment resulted in a rapid involution of the papules, with persistence of the other skin findings. Two patients had a history of dyslipidemia and allergic contact dermatitis. All biopsy specimens showed alterations in the appearance and quantity of sebaceous glands, as reported in previous case series.
Oral isotretinoin is a useful therapeutic alternative in patients with facial papules and frontal fibrosing alopecia, however, it does not modify other associated skin lesions.


REFERENCES

  1. Tan KT y Messenger AG, Frontal fibrosing alopecia: clinical presentations and prognosis, Br J Dermatol 2009; 160:75-9. doi: 10.1111/j.1365- 2133.2008.08861.x.

  2. Abbas O, Chedraoui A y Ghosn S, Frontal fibrosing alopecia presenting with components of Piccardi-Lassueur-Graham-Little syndrome, J Am Acad Dermatol 2007; 57:15-8. doi: 10.1016/j.jaad.2006.11.010.

  3. Pham CT, Hosking AM, Cox S y Mesinkovska NA, Therapeutic response of facial papules and inflammation in frontal fibrosing alopecia to low-dose oral isotretinoin, jaad Case Rep 2020; 6(5):453-6. doi: 10.1016/j.jdcr.2020.01.030.

  4. Iorizzo M y Tosti A, Frontal fibrosing alopecia: an update on pathogenesis, diagnosis, and treatment, Am J Clin Dermatol 2019; 20(3):379- 90. doi: 10.1007/s40257-019-00424-y.

  5. Vañó-Galván S, Molina A, Serrano C, Arias S, Rodrigues A, Garnacho G et al., Frontal fibrosing alopecia: a multicenter review of 355 patients, J Am Acad Dermatol 2014; 70:670-8. doi: 10.1016/j.jaad.2013.12.003.

  6. Kossard S, Postmenopausal frontal fibrosing alopecia. Scarring alopecia in a pattern distribution, Arch Dermatol 1994; 130:770-4.

  7. Krueger L, Svigos K, Brinster N y Elbuluk N, Frontal fibrosing alopecia: cutaneous associations in women with skin of color, Cutis 2018; 102:335-8.

  8. Pirmez R, Donati A, Valente NS, Sodré CT y Tosti A, Glabellar red dots in frontal fibrosing alopecia: a further clinical sign of vellus follicle involvement, Br J Dermatol 2014; 170(3):745-6. doi: 10.1111/bjd.12683.

  9. Vañó-Galván S, Rodrigues-Barata AR, Urech M, Jiménez-Gómez N, Saceda-Corralo D, Paoli J et al., Depression of the frontal veins: a new clinical sign of frontal fibrosing alopecia, J Am Acad Dermatol 2015; 72(6):1087-8. doi: 10.1016/j.jaad.2015.02.1129.

  10. Dlova NC, Frontal fibrosing alopecia and lichen planus pigmentosus: is there a link?, Br J Dermatol 2013; 168(2):439-42. doi: 10.1111/j.1365- 2133.2012.1114.

  11. Miteva M y Goldberg LJ, Lichenoid folliculitis in facial lichen planus pigmentosus: a clue to frontal fibrosing alopecia?, J Cutan Pathol 2020. doi: 10.1111/cup.13715.

  12. Pirmez R, Barreto T, Duque-Estrada B, Quintella DC y Cuzzi T, Histopathology of facial papules in frontal fibrosing alopecia and therapeutic response to oral isotretinoin, J Am Acad Dermatol 2018; 78:e45. doi: 10.1016/j.jaad.2017.10.038.

  13. Pedrosa AF, Duarte AF, Haneke E y Correia O, Yellow facial papules associated with frontal fibrosing alopecia: a distinct histologic pattern and response to isotretinoin, J Am Acad Dermatol 2017; 77:764-6. doi: 10.1016/j.jaad.2017.04.1118.

  14. Pirmez R, Duque-Estrada B, Barreto T, Quintella DC y Cruzzi T, Successful treatment of facial papules in frontal fibrosing alopecia with oral isotretinoin, Skin Appendage Disord 2017; 3:111-3. doi: 10.1159/000464334.

  15. Vañó-Galván S, Saceda-Corralo D, Blume-Peytavi U, Cuchía J, Dlova NC, Gavazzoni Dias MF et al., Frequency of the types of alopecia at twenty-two specialist hair clinics: a multicenter study, Skin Appendage Disord 2019; 5(5):309-15. doi: 10.1159/000496708.

  16. López-Pestaña A, Tuneu A, Lobo C, Ormaechea N, Zubizarreta J, Vildosola S et al., Facial lesions in frontal fibrosing alopecia (ffa): clinicopathological features in a series of 12 cases, J Am Acad Dermatol 2015; 73(987):e1-6. doi: 10.1016/j.jaad.2015.08.020.

  17. Chew AL, Bashir SJ, Wain EM, Fenton DA y Stefanato CM, Expanding the spectrum of frontal fibrosing alopecia: a unifying concept, J Am Acad Dermatol 2010; 653-60. doi: 10.1016/j.jaad.2009.09.020.

  18. Rocha VB, Donati A, Contin LA, Kakizaki P, Machado CJ, Brito FF et al., Photopatch and patch testing in 63 patients with frontal fibrosing alopecia: a case series, Br J Dermatol 2018; 179:1402-3. doi: 10.1111/bjd.16933.

  19. Cranwell WC y Sinclair R, Sunscreen and facial skin care products in frontal fibrosing alopecia: a case control study, Br J Dermatol 2019; 180(4):943-4. doi: 10.1111/bjd.17354.

  20. Robinson G, McMichael A, Wang SQ y Lim HW, Sunscreen and frontal fibrosing alopecia: a review. J Am Acad Dermatol 2020; 82(3):723-8. doi: 10.1016/j.jaad.2019.09.085.

  21. Donati A, Molina L, Doche I, Valente N y Romiti R, Facial papules in frontal fibrosing alopecia: evidence of vellus follicle involvement, Arch Dermatol 2011; 147:1424-7. doi: 10.1001/archdermatol.2011.321.

  22. Mervis JS, Borda LJ y Miteva M, Facial and extrafacial lesions in an ethnically diverse series of 91 patients with frontal fibrosing alopecia followed at a single center, Dermatology 2019; 235(2):112-9. doi: 10.1159/000494603.

  23. Pedrosa AF, Duarte AF, Haneke E y Correia O, Reply to: Histopathology of facial papules in frontal fibrosing alopecia and therapeutic rejeres sponse to oral isotretinoin, J Am Acad Dermatol 2018; 78(2):e47-e48. doi: 10.1016/j.jaad.2017.10.037.

  24. Flores-Terry MÁ, García-Arpa M, Franco-Muñoz M y González-Ruiz L, Facial papules in frontal fibrosing alopecia: good response to isotretinoin, Actas Dermosifiliogr 2018; 109:831-3. doi: 10.1016/j.ad.2017.08.018.

  25. Namazi N, Niknezhad N, Niknejad N y Asadi-Kani Z, Familial facial lichen planopilaris and satisfactory response to isotretinoin, Dermatol Ther 2018; 31(5):e12633. doi: 10.1111/dth.12633.

  26. Zouboulis CC, Isotretinoin revisited: pluripotent effects on human sebaceous gland cells, J Invest Dermatol 2006; 126:2154-6. doi: 10.1038/ sj.jid.5700418.

  27. Pirmez R, Barreto T, Duque-Estrada B, Quintella DC y Cruzzi T, Facial papules in frontal fibrosing alopecia: beyond vellus hair follicle involvement, Skin Appendage Disord 2018; 4(3):145-9. doi: 10.1159/000481695.

  28. Bravo BS, Azulay DR, Luiz RR, Mandarim de Lacerda CA, Cuzzi T et al., Oral isotretinoin in photoaging: objective histological evidence of efficacy and durability, An Bras Dermatol 2015; 90(4):479-86. doi: 10.1590/ abd1806-4841.20153703.




2020     |     www.medigraphic.com