Primary Cicatricial Alopecia: Recent Advances in Understanding and Management

November 2011 in “ The Journal of Dermatology ”

Manabu Ohyama

primary cicatricial alopecia PCA dermoscopy pathological preparation technique direct immunofluorescence bulge stem cells lipid metabolism dysregulation PPAR-y agonists high-throughput screening methods scarring alopecia PPAR-gamma agonists

Studysummary This review discusses recent advancements in the management and diagnosis of primary cicatricial alopecias but reports no new clinical results; emerging insights suggest sebaceous gland dysfunction may play a role in their etiopathogenesis.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The document from 2011 reviews the pathogenesis and management of primary cicatricial alopecia (PCA), highlighting the importance of accurate diagnosis using dermoscopy, a new pathological preparation technique, and direct immunofluorescence. It discusses the role of bulge stem cells, lipid metabolism dysregulation, and various other factors in PCA development. Novel therapeutic approaches, such as PPAR-y agonists, are proposed based on the understanding of these mechanisms. The document also emphasizes the potential of high-throughput screening methods for understanding PCA and developing treatments, while acknowledging the challenges in diagnosis and treatment. It does not provide specific numbers of people involved in studies, focusing instead on molecular and clinical research advancements.

View this study on onlinelibrary.wiley.com →

Discuss this study in the Community →

Research cited in this study

36 / 36 results

research Sebaceous Gland Loss and Inflammation in Scarring Alopecia: A Potential Role in Pathogenesis

37 citations , June 2011 in “Journal of The American Academy of Dermatology”

This study demonstrates that sebaceous gland loss is a common early feature in primary scarring alopecia and suggests that inflammation of sebaceous glands or ducts may contribute to follicular damage.

research Hair Follicle Stem Cells Provide a Functional Niche for Melanocyte Stem Cells

283 citations , February 2011 in “Cell stem cell”

COL17A1 is crucial for preventing hair graying and loss by supporting hair and pigment stem cells.

research The HoVert Technique: A Novel Method for the Sectioning of Alopecia Biopsies

44 citations , January 2011 in “Journal of Cutaneous Pathology”

This study introduces the "HoVert" technique, which generates both vertical and horizontal sections from a single biopsy to effectively differentiate lichen planopilaris from discoid lupus erythematosus in alopecia cases.

research Trichoscopy for Common Hair Loss Diseases: Algorithmic Method for Diagnosis

89 citations , December 2010 in “The Journal of Dermatology”

This study describes characteristic trichoscopic features of various hair loss diseases and proposes an algorithmic method for diagnosing them, but reports no new clinical results.

research Central Hair Loss in African American Women: Incidence and Potential Risk Factors

76 citations , November 2010 in “Journal of The American Academy of Dermatology”

In this study, a photographic scale and questionnaire revealed that extensive central scalp hair loss was observed in 5.6% of African American women, with an association to a history of tinea capitis.

research The Pathogenesis of Primary Cicatricial Alopecias

150 citations , October 2010 in “The American Journal of Pathology”

This review discusses the pathogenesis and challenges in treating primary cicatricial alopecia, highlighting the need to understand immune protection collapse in hair follicle stem cells; it reports no new clinical results.

research Canine Follicle Stem Cell Candidates Reside in the Bulge and Share Characteristic Features with Human Bulge Cells

36 citations , April 2010 in “The journal of investigative dermatology/Journal of investigative dermatology”

This study found that canine bulge-derived keratinocytes are highly proliferative and can reconstitute pilosebaceous structures, indicating their potential utility in studying human stem cell biology and hair disorders.

research Expression of Snail1 in the Fibrotic Dermis of Postmenopausal Frontal Fibrosing Alopecia: Possible Involvement of an Epithelial-Mesenchymal Transition and a Review of Japanese Patients

29 citations , February 2010 in “British Journal of Dermatology”

This study explores the expression of Snail1 in the fibrotic dermis of postmenopausal women with frontal fibrosing alopecia, suggesting a possible link to epithelial-mesenchymal transition.

research Lichen Planopilaris Treated With a Peroxisome Proliferator-Activated Receptor Gamma Agonist

105 citations , December 2009 in “Archives of dermatology”

This overview discusses primary cicatricial alopecias, focusing on lichen planopilaris, and highlights the challenges in treatment and the progressive nature of hair loss despite symptom management, without providing new clinical results.

research Does Collapse of Immune Privilege in the Hair-Follicle Bulge Play a Role in the Pathogenesis of Primary Cicatricial Alopecia?

39 citations , November 2009 in “Clinical and Experimental Dermatology”

This study reports that in primary cicatricial alopecias, increased expression of certain immune markers in the hair-follicle bulge suggests a collapse of immune privilege, which may contribute to follicle destruction.

research Folliculitis Decalvans Developing 20 Years After Hair Restoration Surgery in Punch Grafts: Case Report

11 citations , August 2009 in “Dermatologic Surgery”

A man developed a rare scalp disorder, Folliculitis Decalvans, 20 years after hair restoration surgery, and it required long-term antibiotic treatment.

research Lrig1 Expression Defines a Distinct Multipotent Stem Cell Population in Mammalian Epidermis

503 citations , May 2009 in “Cell stem cell”

This study suggests that Lrig1-positive cells form a previously unknown reservoir of interfollicular epidermal stem cells in adult mouse skin, influencing epidermal proliferation and hair follicle development.

research Lgr5 Marks Cycling, Yet Long-Lived, Hair Follicle Stem Cells

835 citations , October 2008 in “Nature Genetics”

Lgr5 is a marker for active, long-lasting stem cells in mouse hair follicles.

research Etiology of Cicatricial Alopecias: A Basic Science Point of View

35 citations , July 2008 in “Dermatologic therapy”

This review discusses current hypotheses about cicatricial alopecia's pathogenesis, including lymphocyte-mediated mechanisms and sebaceous gland defects, and reports no new results, emphasizing the need for systematic research.

research Cicatricial Alopecia: Classification and Histopathology

74 citations , July 2008 in “Dermatologic therapy”

This review discusses histopathologic findings in diagnosing primary cicatricial alopecias and emphasizes the importance of correlating histology with clinical presentation for accurate diagnosis; it reports no new results.

research Management of Primary Cicatricial Alopecias: Options for Treatment

98 citations , May 2008 in “British Journal of Dermatology”

This review discusses evidence-based guidance for managing primary cicatricial alopecias but reports no new clinical results, highlighting significant gaps in knowledge and the need for more quality trials.

research The Cell-Surface Marker MTS24 Identifies a Novel Population of Follicular Keratinocytes With Characteristics of Progenitor Cells

207 citations , July 2006 in “Development”

This study identified a novel MTS24-positive murine keratinocyte population with increased colony-forming ability, suggesting these cells may serve as a new reservoir of proliferative progenitor or stem cells in hair follicles.

research Report From The Cicatricial Alopecia Colloquium

15 citations , February 2006 in “Journal of Investigative Dermatology”

More research is needed to understand and treat cicatricial alopecias.

research Characterization and Isolation of Stem Cell-Enriched Human Hair Follicle Bulge Cells

550 citations , December 2005 in “The Journal of clinical investigation/The journal of clinical investigation”

This study found that bulge cells marked by CD200+ in human hair follicles show high colony-forming efficiency, suggesting successful enrichment of keratinocyte stem cells.

research Hair Growth Inhibition by Psychoemotional Stress: A Mouse Model for Neural Mechanisms in Hair Growth Control

127 citations , December 2005 in “Experimental Dermatology”

This study provides evidence that psychoemotional stress inhibits hair growth in mice by affecting the brain-hair follicle axis, with specific neuropeptides and treatments modulating this effect.

research Stem Cells in the Hair Follicle Bulge Contribute to Wound Repair but Not to Homeostasis of the Epidermis

1279 citations , November 2005 in “Nature Medicine”

research Hair Transplantation: Current Concepts and Techniques

30 citations , October 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

This article reviews modern hair transplantation techniques, noting that while many innovations have improved natural-looking results and expanded candidate eligibility, some may have hidden drawbacks, and it reports no new results.

research Long-Term Renewal of Hair Follicles from Clonogenic Multipotent Stem Cells

291 citations , October 2005 in “Proceedings of the National Academy of Sciences of the United States of America”

This study found that rat whisker follicle stem cells can be expanded in culture and transplanted to form functional hair follicles, demonstrating their multipotency and potential for regenerative medicine.

research Vertical vs. Transverse Sections in Alopecia Biopsy Diagnosis

33 citations , August 2005 in “The American Journal of Dermatopathology”

This article provides departmental contact information for Dr. Dirk M. Elston at the Geisinger Medical Center and reports no research findings.

research Reorganization of Hair Follicles in Human Skin Organ Culture Induced by Cultured Human Follicle-Derived Cells

56 citations , July 2005 in “Experimental Dermatology”

This study demonstrated that hair follicle-derived cells can induce hair follicle formation in an in vitro skin organ culture system using human retroauricular skin specimens.

research Defolliculated (Dfl): A Dominant Mouse Mutation Leading to Poor Sebaceous Gland Differentiation and Total Elimination of Pelage Follicles

53 citations , July 2002 in “Journal of Investigative Dermatology”

The Dfl mutation in mice causes poor sebaceous gland function and complete hair loss.

Indications for a Brain-Hair Follicle Axis: Inhibition of Keratinocyte Proliferation and Up-Regulation of Keratinocyte Apoptosis in Telogen Hair Follicles by Stress and Substance P

research Indications for a Brain-Hair Follicle Axis: Inhibition of Keratinocyte Proliferation and Up-Regulation of Keratinocyte Apoptosis in Telogen Hair Follicles by Stress and Substance P

125 citations , September 2001 in “The FASEB Journal”

This study demonstrated that stress inhibited hair growth in mice, likely through substance P-dependent activation of immune cells, highlighting a brain-hair follicle connection.

research Hair-Cycle-Associated Remodeling of the Peptidergic Innervation of Murine Skin and Hair Growth Modulation by Neuropeptides

112 citations , February 2001 in “Journal of Investigative Dermatology”

This study found that substance P and calcitonin-gene-related peptide have different roles in regulating hair growth in mice, with substance P promoting anagen progression and calcitonin-gene-related peptide inhibiting it.

research Morphogenesis and Renewal of Hair Follicles from Adult Multipotent Stem Cells

949 citations , January 2001 in “Cell”

This study demonstrated that multipotent stem cells in adult mice whisker follicles migrate to produce whisker growth, and that this process requires precise control of stem cell trafficking.

research Involvement of Follicular Stem Cells in Forming Not Only the Follicle but Also the Epidermis

1010 citations , August 2000 in “Cell”

In this study, researchers found that hair follicle stem cells in mice can generate both hair follicle and epidermis cells, highlighting their potential bipotency.

research Simultaneous Occurrence of Folliculitis Decalvans Capillitii in Identical Twins

39 citations , July 2000 in “British Journal of Dermatology”

This report on identical female twins with folliculitis decalvans suggests a possible genetic component to the disease, marking the first such case in twins.

research Asebia-2J (Scd1ab2J): A New Allele and a Model for Scarring Alopecia

179 citations , June 2000 in “The American journal of pathology”

This study reports that the asebia-2J mutation in mice affects sebaceous gland function and leads to hair follicle destruction, offering a model for human scarring alopecias.

research Elastic Tissue in Scars and Alopecia

80 citations , March 2000 in “Journal of cutaneous pathology”

This study found that the Verhoeff-Van Gieson stain effectively distinguishes scarred from non-scarred dermis and aids in classifying types of permanent alopecia based on elastic tissue patterns.

research Acquired Scalp Alopecia: A Review

37 citations , May 1999 in “Australasian Journal of Dermatology”

This review discusses neutrophil-associated and infiltrative scarring alopecias, as well as promising new treatments, but reports no new clinical results.

research Pseudopelade: An Inherited Alopecia

19 citations , October 1996 in “International Journal of Dermatology”

This study concluded that pseudopelade is an autosomal dominant condition, distinct from other forms of alopecia, characterized by atrophic hair follicle loss and notable familial association.

research Hot Comb Alopecia

107 citations , September 1968 in “Archives of Dermatology”

In this study, researchers identified a form of irreversible scalp alopecia in Black women using hot combs, characterized by incomplete hair loss primarily on the crown and follicular scarring.