Open AccessA comment on frontal fibrosing alopecia (Axel munthe's syndrome)
Author(s) -
Ralph M. Trüeb
Publication year - 2016
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 - 10.4103/0974-7753.203176
Subject(s) - scarring alopecia , etiology , dermatology , presentation (obstetrics) , memoir , disease , medicine , hair loss , pathology , history , scalp , surgery , art history
Frontal fibrosing alopecia (FFA) represents a peculiar condition with a quasi-symmetrical, marginal alopecia along the frontal and temporal hairline with scarring. Steven Kossard is credited with the original description of the condition in 1994. Since its first description, FFA has become increasingly common while its etiology has remained obscure. While FFA has been related to lichen planopilaris, in fact, the pattern of clinical disease presentation might be more specific for the condition than the underlying inflammatory autoimmune reaction. It has been speculated as to whether FFA existed before Kossard's original report since artistic depictions dating from the 15 th to 16 th century often show a high frontotemporal hairline. Rather, these represent fashionable forms of frontal pseudo-alopecia than FFA. Nevertheless, there is compelling evidence that FFA existed well before 1994 from the Swedish Physician Axel Munthe's (1857-1948) account of the distinctive features of the condition in his book of memoirs "The Story of San Michele." Therefore, Axel Munthe is to be acknowledged the first description of FFA in 1929.