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 ”

Amy McMicheal, Susan Taylor, Valerie Callender, Tiffany Mayo, Susan Ball, Fionn McSwiney, Najwa Somani, Chesahna Kindred

central centrifugal cicatricial alopecia traction alopecia alopecia areata scarring alopecia fringe sign scalp biopsy

The study highlights the diagnostic challenges in differentiating alopecia areata (AA) from other types of alopecia in Black patients, particularly women, using photographic evidence from the BRAVE-AA1 clinical trial. Of 36 patients reviewed, 33% were diagnosed with central centrifugal cicatricial alopecia (CCCA) or other scarring alopecia, with 11 of these being female. Key diagnostic signs include specific scalp patterns and 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 symptoms and that multiple types of hair loss can coexist in a single patient, complicating treatment outcomes. While photographs provide valuable diagnostic clues, they are not definitive without scalp biopsies.

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

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