[Frontal fibrosing alopecia: Report on three pediatric cases]

Abstract

Background: Frontal fibrosing alopecia is a topographic form of lichen planopilaris, which most commonly affects postmenopausal women. We report on three original pediatric cases of this scarring alopecia, including one case of female twins.

Observations: The first observation concerns twin sisters, 14 years of age, with frontotemporal symmetric and progressive alopecia, beginning at the age of 5 years, with follicular facial noninflammatory micropapules. Histological examination showed a depletion of hair follicles with dermal fibrosis and perivascular infiltrate. The treatment decided was monthly intralesional infiltrations of betamethasone. The second case is a 7-year-old girl, with a frontotemporal alopecia band and partial alopecia of the eyebrows. Histological examination was consistent with lichen planopilaris. The outcome was favorable after six monthly oral boluses of steroids.

Comment and conclusion: The initial description of frontal fibrosing alopecia was made in postmenopausal women. Some cases have been reported subsequently in premenopausal women as well as in men, with recent identification of familial cases. To our knowledge, these are the first pediatric cases of this form of alopecia, which is not only postmenopausal.