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Int J Trichology. 2018 Jul-Aug;10(4):169-171. doi: 10.4103/ijt.ijt_37_18.

Autologous Hair Transplantation in Frontal Fibrosing Alopecia.

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Department of Dermatology, Santa Casa Hospital, Porto Alegre, Brazil.
Center for Dermatology and Hair Diseases Professor Trueb, Zurich-Wallisellen, Switzerland.


We report a patient with frontal fibrosing alopecia (FFA), in whom autologous hair transplantation was successfully performed despite evidence of active disease. Since the underlying pathology of FFA is usually lichen planopilaris, reservations, and caveats have been expressed with respect to the risk of köbnerization phenomena following hair transplantation surgery. An important question that arises is how the lichenoid tissue reaction pattern is generated around the hair follicles in FFA. Follicles with some form of damage or malfunction might express cytokine profiles that attract inflammatory cells to assist in damage repair or in the initiation of apoptosis-mediated organ deletion. Alternatively, an as yet unknown antigenic stimulus from the damaged or malfunctioning hair follicle might initiate a lichenoid tissue reaction in the immunogenetically susceptible individual. Therefore, it might be expected that the transplantation of whole healthy hair follicles might less give rise to an inflammatory reaction than the disease itself, as revealed in our case report of successful hair transplantation in FFA.


Frontal fibrosing alopecia; hair transplantation; lichenoid tissue reaction

Conflict of interest statement

This case report represents an integral part of Mariana Scribel's traineeship in Dermato-Trichology in May 2018 at the Center for Dermatology and Hair Diseases Professor Trüeb.

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