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Risk Factors for Frontal Fibrosing Alopecia: a case-control study in a multiracial population.

J Am Acad Dermatol. 2020 Aug 21;:

Authors: Ramos PM, Anzai A, Duque-Estrada B, Farias DC, Melo DF, Mulinari-Brenner F, Pinto GM, Abraham LS, Nogueira Santos LD, Pirmez R, Miot HA

Abstract
BACKGROUND: Frontal fibrosing alopecia (FFA) is a chronic cicatricial alopecia with unknown etiology and a worldwide rising incidence.
OBJECTIVE: The objective of this study was to evaluate the association of FFA with demographic and exposition factors in a Brazilian multiracial population.
METHODS: A multicenter case-control study was conducted in 11 referral centers throughout Brazil. The study was a case-control study that prospectively recruited 902 participants (451 FFA and 451 sex-matched controls). Study participants completed a thorough questionnaire comprising variables grouped as baseline demographic, environmental exposition, diet, hormonal, allergies, and hair and skin care.
RESULTS: When adjusted by sex, age, menopause and skin color, FFA was associated with hair straightening with formalin (OR 3.19), use of ordinary (non-dermatologic) facial soap (OR 2.09) and facial moisturizer (OR 1.99), thyroid disorders (OR 1.69), and rosacea (OR 2.08). Smokers (OR 0.33) and users of anti-residue / clarifying shampoo (OR 0.35), presented a negative association with FFA. There was no association with the use of sunscreen.
LIMITATIONS: Recall bias.
CONCLUSION: The association with moisturizers, odinary facial soap, and hair straightening with formalin and the negative association with anti-residue / clarifying shampoo reinforce the possibility of an exogenous particle triggering FFA.

PMID: 32835739 [PubMed - as supplied by publisher]

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