Response to Lack of Association Between Comorbidities and Central Centrifugal Cicatricial Alopecia: A Retrospective Cohort Study of 153 Patients

The letter discusses a study by Jafari et al. on 153 patients with central centrifugal cicatricial alopecia (CCCA), where no significant differences in comorbidities were found between patients with CCCA and those with nonscarring alopecia. The authors of the letter highlight that their previous study compared comorbidities between patients with CCCA and matched controls from the general population, unlike Jafari et al.'s study. They suggest that the control group in Jafari et al.'s study likely included a large portion of patients with androgenetic alopecia (AGA), which could explain the nonsignificant differences in prevalence of diabetes, dyslipidemia, etc. The authors also note differences in diagnostic methods and the possibility of patients having both CCCA and AGA. They acknowledge the limitations of both studies, including different screening for comorbidities, small sample sizes, and being from a single geographic region. They express hope for larger, more rigorous studies in the future.