Dermoscopy findings of the axilla of women with frontal fibrosing alopecia

• Published in: JEADV clinical practice Vol. 3; no. 2; pp. 616 - 621
• Main Authors: Munck, Andreia, Donati, Aline, Machado, Carla Jorge, Valente, Neusa, Romiti, Ricardo
• Format: Journal Article
• Language: English
• Published: Wiley 01.06.2024
• Subjects: alopecia; axilla; dermoscopy; hair; histology; inflammation
• ISSN: 2768-6566; 2768-6566
• DOI: 10.1002/jvc2.335

Background Frontal fibrosing alopecia (FFA) is a form of inflammatory and cicatricial alopecia, presenting concomitantly with rarefaction of eyebrows and body hair. However, the involvement of body hair in FFA is still poorly investigated. Objectives To compare the dermoscopy findings of axillary hairs in a group of women with FFA with a group of women without FFA. Methods An observational case‐control study was carried out on the dermoscopic findings of the axillary hair in this group of patients with FFA compared to a group of women without FFA, matched by age groups and skin phototypes. Results Thirty women with a clinical and histopathological diagnosis of FFA were included in the study. Dermoscopy of the axilla in patients with FFA revealed the presence of axillary hair in 93.3% and all patients had hairless follicular openings. More than one wire per follicular ostium was observed in 70% of the patients and variability in the diameter of the hairs in 83.3% of the cases. Regarding dermoscopic inflammatory signs, a peripillary brownish halo was present in 83.3% of patients, peripillary scaling in 56.7%, diffuse scaling in 63.3% and pigmented network of the epidermis in 73.3% of the cases. When comparing the dermoscopic findings of the axilla of cases with controls, the chance of occurrence of brownish peripillary halos between cases was higher than double the chance of occurrence of these halos among controls (OR = 2.7; 95% CI: 1.1−7.6; p = 0.029). The rest of variables were not statistically associated with the FFA. Conclusions Dermoscopy of the axilla in patients with FFA revealed that brownish peripillary halos may be a diagnostic clue for FFA in the axillary region. The dermoscopy findings found in the present study allow characterizing the axillary involvement of patients with FFA and recognize the dermoscopic differences with other dermatoses involving this location. In this paper, we describe an observational case‐control and inedited study that compare the dermoscopy findings of axillary hairs in a group of women with FFA with a group of women without FFA. Dermoscopy of the axilla in patients with FFA revealed no signs of axillary cicatricial alopecia and the chance of occurrence of brownish peripillary halos between cases was higher than double the chance of occurrence of these halos among controls.