Reduced sensory perception in frontal fibrosing alopecia: A cross-sectional study

Summary: Abstract Body: Our study aimed to quantitatively compare sensory function in the affected and unaffected forehead and scalp of patients with frontal fibrosing alopecia (FFA) to healthy control participants. FFA is a scarring hair loss condition involving hairline recession and is frequently accompanied by pain, pruritus, and/or burning. Although idiopathic, dysesthesia suggests potential neural-sensory involvement, possibly linked to small nerve fiber neuropathy. We conducted a cross-sectional study with 29 gender-matched FFA patients (N=15) and healthy control participants (N=14). Each participant completed a single-visit battery of eight quantitative sensory testing (QST) parameters [i.e., cold detection threshold (CDT), warm detection threshold (WDT), cold pain thresholds (CPT), heat pain thresholds (HPT), mechanical detection threshold (MDT), mechanical pain threshold (MPT), wind-up ratio (WUR), and pressure pain threshold (PPT)] following a standardized and validated protocol. The QST protocol was administered at two sites for each participant: the unaffected site (1 cm above the glabella) and the affected site (4 cm above the glabella or above the line of demarcation in FFA participants). FFA patients demonstrated increased mean sensory thresholds at the affected forehead site in seven (i.e., CDT, WDT, MPT, WUR, HPT, CPT) of eight QST parameters compared to control participants. Intra-group analysis of FFA patients showed a statistically significant increase in mean thresholds at the affected site when compared to the unaffected site in WDT (p=0.002), CPT (p=0.02), HPT (p<0.001), PPT (p<0.001), and MDT (p=0.003) tests. Our QST findings suggest an altered sensory profile (i.e., hypoesthesia) in FFA compared to control subjects. Future research should focus on correlating these findings with nerve structure and disease severity within a large FFA cohort. Rania Nuwailati², Kim T. Nguyen², Divya R. Alley², Rebecca Freese², George Wilcox², Estephan Moana¹, Maria Hordinsky² 1. TMD Department, University of Minnesota Twin Cities, Minneapolis, MN, United States. 2. University of Minnesota Twin Cities, Minneapolis, MN, United States. Clinical Research: Epidemiology and Observational Research