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.