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Journal of the American Academy of Dermatology
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 14 février 2020
Doi : 10.1016/j.jaad.2019.12.023
accepted : 12 December 2019
Trichoscopy findings of frontal fibrosing alopecia on the eyebrows: A study of 151 cases

Alessandra Anzai, MD a, , Rodrigo Pirmez, MD b, Colombina Vincenzi, MD c, Gabriella Fabbrocini, MD d, Ricardo Romiti, MD, PhD a, Antonella Tosti, MD e
a Department of Dermatology, Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brazil 
b Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia, Rio de Janeiro, Brazil 
c Department of Specialized Experimental and Diagnostic Medicine, Dermatology, Alma Mater Studiorum–Universitá di Bologna, Bologna, Italy 
d Department of Dermatology, University of Naples Federico II, Naples, Italy 
e Department of Dermatology, University of Miami School of Medicine, Miami, Florida 

Reprint requests: Alessandra Anzai, MD, Department of Dermatology, Universidade de São Paulo, Faculdade de Medicina, Ave Dr. Enéas de Carvalho Aguiar, 255 - 3° floor - room 3070, São Paulo - SP, Brazil, 05403-000.Department of DermatologyUniversidade de São PauloFaculdade de MedicinaAve Dr. Enéas de Carvalho Aguiar, 255 - 3° floor - room 3070São Paulo - SP05403-000Brazil

Eyebrow loss (madarosis) is a frequent sign of frontal fibrosing alopecia (FFA), and it can be the first sign of the disease.


To describe trichoscopy findings of FFA on the eyebrows.


The analysis included 151 women with histologically proven diagnosis of FFA and eyebrow loss. Trichoscopy of the eyebrow area was performed with either a FotoFinder videodermatoscope or handheld dermoscope DermLite II pro.


The most frequent signs on trichoscopy were yellow dots (92.7%), multiple pinpoint dots (79.5%), short thin hairs/vellus (76.2%), black dots (66.2%), and dystrophic hairs (60.9%). Tapering hairs were found in 21 (13.9%) patients and dystrophic hairs in 92 (60.9%) patients.


Inner limitations of a case series (there was no comparison with healthy control individuals or patients with other hair disorders) and lack of histologic correlation to the trichoscopy findings.


Although FFA is a scarring alopecia, the most common trichoscopy signs found in the eyebrows are usually related to noncicatricial alopecia. Therefore, in most cases, trichoscopy of the eyebrows does not resemble the trichoscopy of FFA on the scalp. Black dots, dystrophic hairs, and broken hairs are frequent signs. Occasionally, tapered hairs can be present on the eyebrows in FFA, leading to misdiagnosis of alopecia areata.

The full text of this article is available in PDF format.

Key words : alopecia, dermatoscopy, dermoscopy, eyebrows, frontal fibrosing alopecia, hair loss, madarosis, trichoscopy

Abbreviations used : AA, FFA, FST

 Funding sources: None.
 Conflicts of interest: None disclosed.
 IRB approval status: Approved by the IRB at the University Hospital in São Paulo, Brazil.

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