MADAM, Frontal fibrosing alopecia (FFA) is a cicatricial alopecia that was first described by Kossard in 1994.1 It primarily affects caucasian postmenopausal women with progressive recession of the frontotemporal hairline. In recent years the disease has been increasingly reported in Europe,2–4 the U.S.A.5 and Japan.6 Most authors consider FFA a variant of lichen planopilaris because of its similar pathological features. Three reports of familial cases of FFA have been published in the literature; 7–9 however, recent articles with large case series of FFA do not discuss the possibility that the disease may occur in families.2–5 We report four new familial cases of FFA including two families with involvement of three members.

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