An otherwise healthy adult woman presented with progressive hair loss of 6 months’ duration associated with pruritus and burning of the anterior scalp. Physical examination revealed frontal and temporal hair loss, with associated “lonely hairs,” perifollicular erythema, and scaling. Loss of eyebrow hair, depression of temporal and frontal veins, and numerous yellow papules on the forehead and temples were also noted (Figure). A clinical diagnosis of frontal fibrosing alopecia (FFA) was made. Treatment was initiated with 400 mg/d of hydroxychloroquine, 2.5 mg/d finasteride, and topical clobetasol propionate, 0.05%. In addition, 10 mg/d of isotretinoin was also prescribed for the treatment of facial papules. One month into therapy, pruritus had resolved and facial papules had notably decreased in size and number. Perifollicular erythema and scaling were also improved. Treatment with isotretinoin was discontinued after 4 months with near complete resolution of facial papules. Treatment with hydroxychloroquine and finasteride was continued with pimecrolimus, 1%, topical cream, without further progression.

一名其他方面健康的成年女性，出现持续6个月的脱发，并伴有瘙痒和前头皮灼伤。体格检查发现额部和颞部脱发，伴有“孤独的头发”，滤泡性红斑和脱屑。还注意到了眉毛的脱落，颞和额静脉的凹陷以及额头和太阳穴上的许多黄色丘疹（图）。进行了额叶纤维化脱发（FFA）的临床诊断。用400 mg / d的羟氯喹，2.5 mg / d的非那雄胺和0.05％的丙酸氯倍他索局部治疗开始治疗。此外，还规定了10 mg / d的异维A酸治疗面部丘疹。进入治疗一个月后，瘙痒症状已缓解，面部丘疹的大小和数量均明显减少。滤泡周围的红斑和鳞屑也得到改善。异维A酸的治疗在4个月后中止，面部丘疹几乎完全消退。吡美莫司（1％）局部用霜继续用羟氯喹和非那雄胺治疗，无进一步进展。