Open AccessFrontal fibrosing alopecia and lupus overlap in a man: Guilt by association?
Author(s) -
Sabrina Khan,
David A. Fenton,
Catherine M. Stefanato
Publication year - 2013
Publication title -
international journal of trichology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 22
eISSN - 0974-9241
pISSN - 0974-7753
DOI - 10.4103/0974-7753.130420
Subject(s) - medicine , systemic lupus erythematosus , scarring alopecia , anti nuclear antibody , lupus anticoagulant , pathology , scalp , dermatology , lupus erythematosus , overlap syndrome , immunofluorescence , alopecia areata , autoantibody , disease , immunology , antibody
Frontal fibrosing alopecia (FFA) is a scarring alopecia, now an accepted subset variant of lichen planopilaris (LPP). Its occurrence in males is rare, with only nine cases reported to date. We describe a case of FFA in a male in association with lupus erythematosus. Multiple biopsies from the scalp, eyebrow and arm showed features consistent with LPP, in keeping with the clinical presentation of FFA. Direct immunofluorescence studies showed a positive lupus band test. Further serological investigation confirmed the presence of antinuclear, anticardiolipin and lupus anticoagulant antibodies. Whilst the findings of lupus erythematosus may be coincidental or a forme fruste of the disease occurring in association with FFA, it is feasible that lupus and LPP may occur as an overlap syndrome. This case underscores the importance of multiple biopsies and the role of direct immunofluorescence in disclosing more than one pathology in the follow-up of patients with scarring alopecia.