Alopecia Areata With an <scp>FFA</scp> ‐Like Phenotype: Clinicopathologic Features and Treatment Outcomes in a Prospective Cohort

This study investigates a unique presentation of alopecia areata (AA) that resembles frontal fibrosing alopecia (FFA), characterized by frontotemporal hairline recession with isolated single hairs. Involving 56 patients, the study found that more than half had a history of patchy AA, and trichoscopy revealed a predominance of 1-hair follicular units at the hairline. Histopathology showed preserved pilosebaceous units and increased telogen follicles without scarring. Treatment outcomes indicated limited improvement, with a median SALT score change of 0% at 3 months and 18.4% at 6 months. Only 20% of patients showed significant improvement by the last follow-up. Compared to patchy AA, this phenotype had a lower response to corticosteroids at 3 months. The findings suggest a chronic course with limited hair regrowth for this FFA-like AA phenotype.