Pruebas de parche n Alopecia Frontal Fibrosante

Published in Dermatology

Journal Scan / Research · February 12, 2020

Patch Testing and Contact Allergen Avoidance in Patients With Lichen Planopilaris and/or Frontal Fibrosing Alopecia

Journal of the American Academy of Dermatology

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• In this study, 42 predominantly Caucasian women with lichen planopilaris (LPP) from a specialty alopecia clinic were referred for patch testing. All patients had been on stable systemic regimens for 6 months prior to patch testing and were continued on these regimens. Approximately, 76% had clinically relevant allergens on patch testing. Most common were gallates (26.2%), linalool (19%), and fragrance mix (19%). At 3 months of allergen avoidance, around 58% and 73% of patients reported a decrease in their scalp pruritus and erythema, respectively.

• Although this study lacked a control group, the authors suggest that allergens could play a role in cicatricial alopecia development, and, in some cases, may represent a lichenoid type of contact allergy of the scalp. Given the high percentage of relevant allergens in patients with LPP, routine patch testing may be considered.

– Margaret Hammond, MD

Written by

 

 

Christen Maria MowadMD

Allergic contact dermatitis (ACD) is a common problem. This study was designed to assess the possible role of ACD and contact allergens in patients with lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA). The patients studied all had pathology consistent with LPP or FFA. The authors patch tested these patients and found that 76% of patients with LPP, FFA, or LPP/FAA had relevant allergens that were in their cosmetics and personal care products applied to their scalp and face. Many of these allergens were fragrances, linalool, and gallates. The smaller group of patients who had allergens and who were available to complete a study of 3 months of allergen avoidance noted less scalp erythema and less itching at the 3-month follow-up. The role of these allergens and ACD in the development of LPP or FFA is not confirmed in this study. The authors raise the question of whether this is a cause and effect or if these patients are more prone to ACD, perhaps because of the underlying process. More studies will be needed to better discern the relationship or causality, if any, between ACD and the development of LPP or FAA.

Abstract

The incidence of frontal fibrosing alopecia (FFA) has increased since 1994, suggesting environmental causes in disease etiology. The development of FFA has been linked to a xenobiotic-processing enzyme genetic defect, but the exact etio-pathogenesis is still unknown. Patch testing in British and Brazilian FFA patients identified five potentially relevant allergens. This study seeks to identify relevant allergens in FFA and/or lichen planopilaris (LPP) patients, and assess whether avoidance of relevant allergens impacts patients' alopecia symptoms and disease activity.

Journal of the American Academy of Dermatology

Patch Testing and Contact Allergen Avoidance in Patients With Lichen Planopilaris and/or Frontal Fibrosing Alopecia: A Cohort Study

J Am Acad Dermatol 2020 Jan 18;[EPub Ahead of Print], S Prasad, DH Marks, LJ Burns, B De Souza, EA Flynn, P Scheinman, D Silvestri, J Yu, K LoSicco, MM Senna 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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