Cicatricial Alopecia: Classification and Histopathology

July 2008 in “ Dermatologic therapy ”

Najwa Somani, Wilma F. Bergfeld

cicatricial alopecia folliculocentric inflammation hair follicles irreversible hair loss lymphocytic neutrophilic mixed histopathology special stains direct immunofluorescence

TLDR Early detection and histopathology are crucial to prevent permanent hair loss in cicatricial alopecia.

Primary cicatricial alopecias were a complex group of disorders marked by folliculocentric inflammation leading to the destruction of hair follicles and irreversible hair loss. They were classified based on the predominant cell type present: lymphocytic, neutrophilic, or mixed. Histopathology played a crucial role in diagnosis, with early detection being essential to prevent permanent hair loss. The review highlighted key histopathologic findings and additional diagnostic clues from special stains and direct immunofluorescence studies. Despite thorough evaluation, accurate diagnosis could be challenging due to overlapping features among the disorders, emphasizing the importance of correlating histology with clinical presentation.

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Research cited in this study

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research Ichthyosis Follicularis With Alopecia and Photophobia

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research Immunofluorescent Findings and Clinical Overlap in Two Cases of Follicular Lichen Planus

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research Erosive Pustular Dermatosis of the Scalp

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