Contact Sensitization in Patients With Frontal Fibrosing Alopecia: Patch Test Results With an Extended Baseline Series in Consecutive Patients

Abstract

INTRODUCTION: Contact sensitization has been reported in patients with frontal fibrosing alopecia (FFA). OBJECTIVES: To analyse sensitization in FFA-patients and the improvement of symptoms after allergen avoidance. METHODS: We performed patch tests with an extended baseline series in FFA-patients across Spain and assessed the allergen avoidance impact. RESULTS: 133 FFA-patients were investigated. 97% were women. At least one positive allergen was found in 77/133 (58%). No differences were detected in the frequency of positive results compared with the population without FFA patch tested with an extended baseline series in the same period (52.3%) (p = 0.21). Having FFA was associated with being sensitized to propolis, shellac, and gallate mixture. Thirteen (9.8%) patients showed sensitization to salicylates, which was associated with subjective symptoms of intolerance to sunscreens or sun exposure. No evidence of clinical improvement was identified with allergen avoidance 4 months after patch testing. CONCLUSION: No sufficient evidence was found to justify routine patch testing in FFA patients, as no evidence of clinical improvement was identified by allergen avoidance and the relevance of FFA-associated sensitizations was largely uncertain. Patch testing with salicylates may be of interest in FFA-patients with subjective symptoms of intolerance to sun exposure or sunscreens.