Differentiating Between Central Centrifugal Cicatricial Alopecia, Traction Alopecia, and Alopecia Areata in Black Patients: Photographic Examples from a Clinical Trial
November 2024
in “
SKIN The Journal of Cutaneous Medicine
”
New to Alopecia Areata? There is a guide in the encyclopedia. Read the guide → 
Studysummary This study highlighted that diagnostic complexities can lead to misdiagnosis of alopecia areata in Black patients, commonly due to similar presentations of scarring alopecias and multiple hair loss types co-occurring within a single patient.
Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer
The study highlights the diagnostic challenges in differentiating between Central Centrifugal Cicatricial Alopecia (CCCA), Traction Alopecia, and Alopecia Areata (AA) in Black patients, using photographic evidence from a clinical trial. In the BRAVE-AA1 addendum 5 study, 36 patients' scalp photographs were reviewed, revealing that 33% were diagnosed with CCCA or other scarring alopecia, predominantly in females. Key diagnostic signs included scalp pigmentation changes for CCCA, the "fringe sign" for traction alopecia, and asymmetrical bald patches for AA. The study emphasizes that misdiagnosis can occur due to overlapping hair loss patterns, and while photographs aid in diagnosis, they are not definitive without biopsies. The findings underscore the importance of visual signs in tailoring treatment plans for alopecia in Black patients.
