Primary Cicatricial Alopecias

April 2010 in “ Expert Review of Dermatology ”

Adel Alsantali, Jerry Shapiro

TLDR The document concludes that early diagnosis and treatment are crucial for managing rare hair loss disorders and that more research is needed to improve treatment strategies.

The document from April 2010 provides a comprehensive review of primary cicatricial alopecias (PCAs), a group of rare inflammatory disorders that result in permanent hair follicle destruction and irreversible hair loss. It categorizes PCAs into lymphocytic, neutrophilic, and mixed types, with specific conditions such as discoid lupus erythematosus (DLE) and lichen planopilaris (LPP) being discussed in detail, including their clinical features, etiology, and treatment options. The article also covers other PCAs like frontal fibrosing alopecia (FFA), pseudopelade of Brocq (PPB), central centrifugal cicatricial alopecia (CCCA), alopecia mucinosa (AM), keratosis follicularis spinulosa decalvans (KFSD), and folliculitis decalvans (FD), providing insights into their presentation and management. The importance of early diagnosis and intervention is emphasized to prevent further hair loss, and the need for controlled clinical trials to evaluate therapeutic options is highlighted, along with the potential for technological advances to improve PCA management strategies.

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Research cited in this study

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research Central Centrifugal Cicatricial Alopecia: Past, Present, and Future

75 citations , March 2009 in “Journal of The American Academy of Dermatology”

CCCA is a hair loss type affecting African women, possibly caused by grooming and chemicals, with various treatments and needing more research.

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No treatment showed clear superiority for lichen planopilaris.

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69 citations , August 2008 in “Journal of The European Academy of Dermatology and Venereology”

Oral dutasteride and topical pimecrolimus can safely and effectively treat Frontal Fibrosing Alopecia, leading to significant hair regrowth.

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74 citations , July 2008 in “Dermatologic therapy”

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

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39 citations , July 2008 in “Dermatologic Therapy”

Pseudopelade of Brocq is a unique hair loss condition, but its cause and development are still not fully understood.

research Central Centrifugal Cicatricial Alopecia

72 citations , July 2008 in “Dermatologic Therapy”

CCCA is a scarring hair loss condition mainly in African descent women, possibly caused by genetics and hairstyling, treated with gentle hair care and medications.

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76 citations , June 2008 in “Journal of the American Academy of Dermatology”

The conclusion is that certain scalp tissue changes are characteristic of lichen planopilaris, with mucinous perifollicular fibroplasia being a new feature for diagnosis.

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32 citations , February 2008 in “Journal of the American Academy of Dermatology”

KFSD is a genetic disorder causing hair loss and skin issues, with no effective treatment.

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35 citations , January 2008 in “American Journal of Clinical Dermatology”

KFSD can be linked to acne keloidalis nuchae and tufted hair folliculitis.

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113 citations , May 2007 in “Journal of the American Academy of Dermatology”

The study found that steroids and tetracycline helped treat active Lichen planopilaris, and hair transplants were good for later stages.

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144 citations , September 2006 in “Clinics in Dermatology”

Lupus affects the body and skin, causing joint pain and skin issues that can be treated with steroids and antimalarial drugs.

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90 citations , June 2006 in “The American Journal of Dermatopathology”

The document concludes that accurate diagnosis of different types of hair loss requires careful examination of hair and scalp tissue, considering both clinical and microscopic features.

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Current treatments for cicatricial alopecia can manage symptoms but don't stop hair loss or the disease.

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123 citations , August 2005 in “Journal of the European Academy of Dermatology and Venereology”

The study found that Frontal Fibrosing Alopecia affects a broader age range of women and early treatment can help stop hair loss.

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36 citations , April 2005 in “British journal of dermatology/British journal of dermatology, Supplement”

Radiation therapy is an effective treatment for severe scalp cellulitis with mild side effects and no long-term complications.

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179 citations , December 2004 in “Journal of The American Academy of Dermatology”

Some postmenopausal women with frontal fibrosing alopecia stopped losing hair with finasteride treatment, hinting at a possible hormonal cause.

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105 citations , April 2004 in “Dermatologic Therapy”

The document concludes that proper diagnosis and a combination of medical, hair-care, and surgical treatments are important for managing alopecia in black women.

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254 citations , December 2003 in “Journal of the American Academy of Dermatology”

Accurate diagnosis and aggressive treatment are crucial to prevent permanent hair loss in cicatricial alopecia.

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21 citations , April 2003 in “Journal of cutaneous medicine and surgery”

Alopecia mucinosa can be treated successfully with minocycline in some cases.

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20 citations , November 2002 in “Journal of the European Academy of Dermatology and Venereology”

Lichen planopilaris may be linked to autoimmune thyroiditis.

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51 citations , October 2002 in “Archives of dermatology”

The document does not conclude the effectiveness of the 800-nm pulsed-diode laser for treating scalp cellulitis.

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29 citations , March 2001 in “Clinics in Dermatology”

Steven Kossard classified lymphocyte-related hair loss into four patterns, each linked to different types of baldness.

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72 citations , November 2000 in “Archives of Dermatology”

Excision with primary closure is an excellent treatment for extensive acne keloidalis nuchae.

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

The VVG stain effectively differentiates scar tissue from normal skin and helps classify types of permanent alopecia.

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226 citations , February 1999 in “British Journal of Dermatology”

Folliculitis decalvans and tufted folliculitis are related, and a new treatment with rifampicin and clindamycin is effective.

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44 citations , November 1998 in “Australasian Journal of Dermatology”

Accurate diagnosis is key for treating different kinds of hair loss, and immune response variations may affect the condition and treatment results.

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329 citations , January 1997 in “Journal of the American Academy of Dermatology”

Frontal fibrosing alopecia is a hair loss condition in postmenopausal women, similar to lichen planopilaris, with ineffective treatments.

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78 citations , April 1994 in “Archives of dermatology”

The study found that Keratosis Pilaris Atrophicans is a genetic skin condition that starts in childhood, involves inflammation and scarring, and current treatments are only somewhat effective.