Enlarging Alopecic Patch in an African American Woman with Central Centrifugal Cicatricial Alopecia: A Case of Concomitant Tinea Incognito

March 2022 in “ JAAD case reports ”

Elizabeth J. Klein, Maria Karim, Carolyn J. Kushner, Jackleen Marji, Prince Adotama, Kristen Lo Sicco, Jerry Shapiro

central centrifugal cicatricial alopecia CCCA corticosteroids Trichophyton tonsurans tinea incognito oral terbinafine terbinafine

TLDR Accurate diagnosis is crucial for effective treatment of hair loss.

This case report discusses a 49-year-old African American woman with central centrifugal cicatricial alopecia (CCCA) who was initially treated with corticosteroids but showed worsening symptoms. A subsequent biopsy revealed a concomitant infection with Trichophyton tonsurans, leading to a diagnosis of tinea incognito. The patient was then treated with oral terbinafine, resulting in marked improvement. This case highlights the importance of considering multiple etiologies in patients with hair loss, especially when they do not respond to standard treatments, and underscores the need for accurate diagnosis to avoid exacerbating conditions with inappropriate therapies.

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Research cited in this study

5 / 5 results

research Primary Cicatricial Alopecia

65 citations , November 2016 in “Journal of The American Academy of Dermatology”

The document concludes that early recognition and treatment of primary cicatricial alopecia is crucial to prevent permanent hair loss.

research Tinea Capitis in Adults

10 citations , January 2016 in “Dermatology online journal”

Adults with persistent scalp issues unresponsive to typical treatments should be tested for the fungal infection tinea capitis to start the right antifungal medication.

research Central Centrifugal Cicatricial Alopecia Presenting with Irregular Patchy Alopecia on the Lateral and Posterior Scalp

19 citations , January 2015 in “Skin appendage disorders”

The report found a new type of hair loss in African-American women that affects more areas of the scalp than previously thought.

research Histopathology of Alopecia: A Clinicopathological Approach to Diagnosis

170 citations , December 2009 in “Histopathology”

The conclusion is that accurate diagnosis of different types of hair loss requires good teamwork between skin doctors and lab experts.

research Tinea Capitis Mimicking Cicatricial Alopecia: What Host and Dermatophyte Factors Lead to This Unusual Clinical Presentation?

21 citations , February 2009 in “Journal of the American Academy of Dermatology”

Some cases of tinea capitis, a fungal scalp infection, can look like scarring hair loss due to the body's immune response and the fungus itself.

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community If You Have DUPA, PLEASE READ THIS: Everyone Should Be Scalp Biopsied

nkrata in Research 830 upvotes 1 year ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

community lost my hair in a single year of treatment at 20 years old

in Finasteride/Dutasteride 90 upvotes 1 year ago

A 20-year-old lost significant hair after one year of treatment, using minoxidil, finasteride, and later dutasteride. They are considering adding RU58841 but are advised to return to finasteride and minoxidil for a year before deciding.

community I am a dermatologist with a clinical interest in alopecia. AMA

in Will treatment work for me? 3 years ago

In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

community scarring alopecia awareness in this community

in Chat 33 upvotes 3 years ago

Lichen Planopilaris (LPP), a form of permanent hair loss, which can be mistaken for seborrheic dermatitis and is characterized by scalp itching, burning, redness, and dandruff. Treatment options discussed include steroidal creams, finasteride, minoxidil, and RU58841.

community Wanted to say that Derma rolling and Pumpkin seed oil helped my crown out.

in Treatment 4 upvotes 6 years ago

Derma rolling, pumpkin seed oil, and daily massages helped regrow weak hairs on the crown. Nizoral shampoo and yoga also contributed to reducing scalp pain and stress.

community Finasteride doesn't work for me in 2 years and my bloodtest result just came in.

in Progress Pictures 88 upvotes 2 years ago

A user has been treating hair loss with finasteride for two years without success and is experiencing an itchy scalp with seborrhea. Despite low DHT levels, they are still losing hair, suggesting that DHT might not be the main cause of their hair loss, and they are considering other treatments or causes.

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research Erosive Pustular Dermatosis of the Scalp: Causes and Treatments

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A rare scalp condition mainly in older women can be treated with various alternatives to steroids, which may have fewer side effects.