Sergio Vano-Galvan

Introduction: Frontal fibrosing alopecia (FFA) is a scarring alopecia increasingly recognized in men, with potential psychological repercussions. This study aimed to assess the impact of FFA on men’s quality of life (QoL). Methods: A multicenter cross-sectional study was conducted including men diagnosed with FFA who completed the Hair-Specific Skindex-29 (HSS29), Women’s AGA Quality of Life Questionnaire (WAA-QoL), and Hospital Anxiety and Depression Scale (HADS). Associations were analyzed using Spearman’s correlation, Kruskal-Wallis, and chi-square tests. Results: Eighty-one men (mean age 54.7 years) participated. Moderate to severe emotional impairment was present in 39.5% of patients, particularly in younger individuals and those with temporal hairline involvement. Mean HADS scores indicated mild psychological distress. Conclusion: FFA significantly affects men’s QoL, especially younger patients, underscoring the need for psychosocial assessment regardless of disease severity. FFA is a type of scarring alopecia that is increasingly affecting men [J Am Acad Dermatol. 2022;86(2):481–484; J Am Acad Dermatol. 2014;70(4):670–678]. A negative impact on the emotional and psychological health of patients has been reported [JAMA Dermatol. 2018;154(4):479–480]. The aim of our study was to evaluate the impact of FFA on the QoL in men.

Lichen planopilaris (LPP) is a primary lymphocytic cicatricial alopecia primarily affecting the vertex or parietal scalp. This immune‐mediated condition involves mainly CD8 ⁺ cytotoxic T cells targeting follicular antigens, causing inflammation and permanent damage to hair follicles. Early diagnosis and prompt intervention are then essential to minimize hair loss and prevent further disease progression. Managing LPP is challenging due to the absence of curative treatments and the unpredictable nature of the disease and treatment responses. This position statement summarizes the results of an extensive literature review analysed through the collective expertise of the European Academy of Dermatology and Venereology (EADV) Task Force on Hair Diseases. Treatment strategies for LPP encompass a range of topical, systemic, and interventional therapies. First‐line treatments often include potent topical and intralesional steroids, which can be used alone or in combination with other therapies. For patients with moderate to severe disease, resistance to topical/intralesional steroids, or a progressive disease course, systemic therapy or a combination approach should be considered, tailored to disease activity, comorbidities, and patient preferences. While there is no known cure for LPP, randomized controlled trials are limited and no head‐to‐head treatment comparisons have been conducted to date, these recommendations should be personalized for each patient.

Introduction: Frontal fibrosing alopecia (FFA) is a scarring alopecia first described in 1994. It is more common in postmenopausal women, and its incidence has increased significantly among both premenopausal and postmenopausal women. FFA is less frequent in men and beard involvement occurs in 50–74% of male FFA patients. This study aimed to assess the clinical and trichoscopic features of beard involvement in FFA patients. Methods: After the Institutional Review Board’s approval, a prospective multicenter study was conducted involving 25 male patients with FFA. Clinical photos were taken and trichoscopic images of 5 areas (sideburns, right-left lateral cheek, mustache, and chin) were obtained. Results: Beard hair loss was observed in all patients. Severe clinical involvement was associated with the presence of facial papules and with numerous concomitant (≥3) features (facial papules; lichen planus pigmentosus; loss of eyebrows, eyelashes, or body hair). Trichoscopic findings were present in all patients. Absence of follicular openings (100%), black dots (64%), perifollicular erythema (56%), broken hairs (56%), telangiectasias (56%), and white dots (48%) were the most prevalent findings. Conclusion: Clinical and trichoscopic beard involvement in male FFA were observed in all patients, and severe involvement including all areas of the beard was observed in half of the patients. The high incidence of facial papules and body hair loss may indicate a more severe clinical profile in men.

Artificial intelligence (AI) is increasingly being incorporated into dermatology, with hair disorders representing a particularly suitable field for its application. The assessment and management of alopecias rely heavily on visual evaluation, pattern recognition, longitudinal monitoring, and integration of heterogeneous clinical and biological data; processes that are often limited by interobserver variability and incomplete standardization. In recent years, AI-based approaches have been applied across multiple domains in the clinical assessment of hair disorders, including objective quantitative assessment, diagnostic support, personalized medicine, drug development, robotic-assisted procedures, and analysis of patient-reported outcomes and clinical communication. Among these applications, tools enabling automated and reproducible measurement of hair parameters are currently the most established in clinical practice, whereas diagnostic and predictive models remain largely investigational. This narrative review summarizes current and emerging applications of artificial intelligence in hair disorders, with a focus on their clinical relevance and practical implementation. In addition, methodological limitations, ethical considerations, and challenges related to external validation, interpretability, and data bias are discussed. Although AI-based tools are not yet able to replace clinical judgement, they hold significant potential to complement dermatologists’ expertise and improve objectivity, efficiency, and personalization in the management of hair disorders.

Alopecia areata (AA) is a complex disease with a multifactorial etiology, in which autoimmune mechanisms play a central role. Increasing evidence suggests that AA may be a systemic condition, potentially affecting organs beyond the skin due to shared pathogenic pathways. One proposed mechanism is the breakdown of immune privilege, a protective state that limits immune activity in specific tissues, such as the hair follicle and the eye. Although research on the relationship between AA and ophthalmic comorbidities remains limited, several studies have reported recurrent ocular abnormalities, whether subclinical or symptomatic, appearing at younger ages than typically observed in the general population. This review aims to summarize current knowledge on the association between AA and ocular involvement, exploring shared pathogenic mechanisms, clinical eye manifestations, and practical considerations for addressing ocular symptoms in dermatological practice.