前额纤维化性脱发二例

Frontal fibrosing alopecia： two case reports

例1女，44岁，额颞部发际线后移4年，面部多发性肤色小丘疹2年。皮肤科检查：额颞部发际线后移，局部皮肤光滑菲薄，可见残存的细小毛发；眉毛、腋毛和阴毛部分脱落；额颞部、双下颌角处可见弥漫性分布许多粟粒大小的肤色小丘疹。皮肤镜下可见毛囊开口数减少，毛发直径不一，瘢痕性白斑和毛囊周围红斑。例2女，55岁，额颞部毛发稀少2年。皮肤科检查：双侧额颞部发际线后移，眉毛、腋毛和阴毛部分脱落。2例患者的组织病理检查均可见毛囊周围以淋巴细胞为主的浸润，基底细胞液化变性，毛囊周围有板层状纤维化。2例患者的临床和组织病理表现均符合前额纤维化性脱发的诊断。

Two cases of frontal fibrosing alopecia （FFA） were reported. Case 1, a 44-year-old woman, presented with progressive recession of the frontotemporal hairline for 4 years and multiple skin-colored facial papules for 2 years. Skin examination showed that the frontotemporal hairline was receded, the local skin was smooth and thin, and a few remaining fine hairs could be seen. Additionally, eyebrows, axillary and pubic hairs were partly shed, and plenty of millet-sized skin-colored papules were diffusedly distributed on the frontotemporal region and bilateral mandibular angles. Dermatoscopy showed reduced hair follicular openings, different hair shaft diameters, cicatricial white patches and perifollicular erythema. Case 2, a 55-year-old woman, presented with progressive frontotemporal hair loss for 2 years. Skin examination revealed the recession of bilateral frontotemporal hairline and partial loss of eyebrows, axillary and pubic hairs. Histopathological examinations of the 2 patients both revealed perifollicular infiltration of lymphocytes, liquefaction degeneration of basal cells and perifollicular lamellar fibrosis. Clinical manifestations and histopathological features of the 2 patients both confirmed the diagnosis of FFA.