ABSTRACT
BACKGROUND: Frontal fibrosing alopecia (FFA) is a scarring alopecia that affects the frontotemporal hairline. Clinically, it may develop with cutaneous hypopigmentation of the affected areas, which has been associated with a reduction in the epidermal melanocyte count. In trichoscopy, peripilar white halos can be observed, which have been associated with fibrosis in other scarring alopecias. OBJECTIVE: To evaluate the trichoscopic, histopathological and immunohistochemical characteristics of the peripilar white halos in FFA patients. MATERIALS AND METHODS: We conducted a descriptive cross-sectional study that included 12 patients with FFA presenting peripilar white halos. Two 2-mm punch trichoscopy-guided biopsies were performed in all patients, one fragment for vertical section and another for horizontal section. The vertical sections were stained with Fontana-Mason and Melan-A. RESULTS: On trichoscopic examination, peripilar white halos ≤ 1 mm in size were observed on the affected scalp. In vertical sections, a reduction in basal melanin pigmentation and a decrease in the melanocyte count in the upper segment of the hair follicle were observed with Fontana-Masson staining and Melan-A immunostaining, respectively. LIMITATIONS: The small sample size and absence of a control group. CONCLUSION: This study shows follicular melanocyte involvement in FFA, and this finding may be associated with the peripilar white halos observed in trichoscopy.
Subject(s)
Alopecia/diagnosis , Hair Follicle/pathology , Melanocytes/pathology , Adult , Aged , Alopecia/pathology , Cross-Sectional Studies , Dermoscopy , Female , Forehead , Humans , Immunohistochemistry , Male , Middle AgedABSTRACT
We report a healthy, 44-year-old woman presenting with an at least a 20-year history of hardened papules in the forehead region, extending to the scalp. The biopsy and histopathologic exam confirmed a diagnosis of osteoma cutis. We review the literature review and discuss the classification of the cutaneous ossification process presented, along with the results of the surgical treatment.