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Annales de Dermatologie et de Vénéréologie
Volume 141, n° 4
pages 272-278 (avril 2014)
Doi : 10.1016/j.annder.2014.01.020
Received : 10 September 2013 ;  accepted : 9 January 2014
L’alopécie frontale fibrosante
Frontal fibrosing alopecia
 

C. Jouanique a, b, P. Reygagne b,
a Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France 
b Centre Sabouraud, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France 

Auteur correspondant.
Résumé

L’alopécie frontale fibrosante (AFF) a été décrite en 1994. Elle est caractérisée par une alopécie cicatricielle en bande touchant la zone antérieure du cuir chevelu. Une alopécie des sourcils est fréquemment associée ainsi que des atteintes axillaire, pubienne, des duvets du visage et des poils du corps. L’AFF est une forme topographique de lichen plan pilaire (LPP). L’examen histologique met en évidence un infiltrat lymphocytaire autour de l’isthme et de l’infundibulum, associé à une diminution du nombre de follicules, remplacés par des tractus fibreux. L’AFF atteint des femmes après la ménopause mais des cas chez l’homme et chez la femme jeune sont décrits. L’incidence de l’AFF augmente. Sa physiopathologie est inconnue. Son évolution se fait vers une stabilisation spontanée en plusieurs années, sans qu’il soit possible de prédire le degré d’extension auquel elle aboutira avant stabilisation. Aucun traitement n’a fait la preuve formelle de son efficacité jusqu’à présent.

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Summary

Frontal fibrosing alopecia (FFA) was first described in 1994. It is characterized by scarring alopecia in bands involving the anterior area of the scalp. Alopecia of the eyebrows is frequently associated, as are pubic, facial and body hair alopecia. The clinical and histologic features are evocative of lichen planopilaris (LPP), and AFF is in fact regarded as a special pattern of LPP. Histology reveals a lymphocytic infiltrate located around the isthmus and follicular infundibulum associated with a decrease in the number of follicles, which are supplanted by fibrous tract. AFF most commonly affects post-menopausal women, but instances have been described in men and in young women. This orphan disease has increased in recent years, with more than 37 articles dedicated to this condition since it was first described in 1994. The pathophysiology remains unknown. The condition develops slowly with spontaneous stabilization over several years but it is impossible to predict the degree of expression prior to stabilization. In this article we review the various treatments proposed, for none of which formal proof of efficacy has been provided to date.

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Mots clés : Alopécie frontale fibrosante, Alopécie cicatricielle, Lichen plan pilaire, Sourcils, Ménopause, Fibrose, Kossard

Keywords : Alopecia, Cicatricial alopecia, Scarring alopecia, Lichen planopilaris, Eyebrow alopecia, Menopause, Fibrosis, Kossard, Lichen planus




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