RESUMEN
BACKGROUND: Frontal fibrosing alopecia (FFA) is a chronic scarring alopecia with an unpredictable evolution. There are no current classifications of this disease that may predict its prognosis. OBJECTIVE: To analyse the differences in clinical presentation and evolution of FFA patients and to create a clinical and prognostic classification. METHODS: We conducted a retrospective analytical study of FFA patients. Clinical characteristics of frontal hairline recession were used as the sorting variable between patterns of presentation. A cohort of 106 patients homogenously treated with oral dutasteride and topical corticosteroid was followed 12 months. RESULTS: In all, 242 female patients with a mean age of 61.4 years were included. Patients were classified into three clinical patterns [118 (48.8%) patients as pattern I (linear), 109 patients (45%) as pattern II (diffuse) and 15 patients (6.2%) as pattern III (double line)]. Stabilization was achieved in 37.3% of the 106 patients treated with oral dutasteride and topical corticosteroid. Pattern III patients had less hairline recession and eyebrow involvement at the diagnosis and after treatment. LIMITATIONS: Retrospective design. CONCLUSIONS: Frontal fibrosing alopecia patients can be classified into three different clinical patterns with different prognosis. Pattern III patients have the best prognosis, while pattern II patients have the worst prognosis.