Central Centrifugal Cicatricial Alopecia Associated With PDL1 Loss and Increased Expression of Caspase 3: A Case Series

    April 2023 in “ American Journal of Dermatopathology ”
    Shane Smith, Navitha Woddor, David S. Cassarino, Wen Chen, Nashay Clemetson, Victor E. Nava
    TLDR CCCA may involve the PD1/PDL1 pathway and increased caspase 3, leading to permanent hair loss.
    This case series investigates central centrifugal cicatricial alopecia (CCCA), a scarring alopecia affecting predominantly patients with skin of color, and its association with PDL1 loss and increased caspase 3 expression. The study highlights that approximately 30% of CCCA cases are linked to peptidyl arginine deiminase 3 misfolding mutations. The findings suggest that CCCA is a CD4-predominant T-cell process, and the observed loss of PDL1 along with increased caspase 3 expression indicates a potential involvement of the PD1/PDL1 pathway in the disease's progression. This research provides insights into the inflammatory mechanisms underlying CCCA, which typically results in progressive and permanent hair loss.
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