Primary Cicatricial Alopecias: Clinicopathology of 112 Cases

This study reviewed 112 cases of primary cicatricial alopecias over 5 years at the University of British Columbia Hair Clinic, representing 3.2% of total consultations. The ratio of lymphocytic to neutrophilic cicatricial alopecias was 4:1, with lymphocytic types more common in middle-aged women and neutrophilic types in middle-aged men. Accurate diagnosis required careful clinicopathologic evaluation and often multiple scalp biopsies. Aggressive, multi-modal treatment was necessary to prevent irreversible follicular destruction, highlighting the urgency of managing cicatricial alopecia. Treatment options included corticosteroids, antimalarials, and isotretinoin for lymphocytic types, and antibiotics, corticosteroids, and isotretinoin for neutrophilic types.