Scalp Psoriasis Associated with Central Centrifugal Cicatricial Alopecia

September 2016 in “ Journal of Dermatology and Dermatologic Surgery ”

Krista N. Larson, Jaclyn A. Smith, Leah A. Cardwell, Steven R. Feldman

central centrifugal cicatricial alopecia scalp psoriasis intralesional steroid injections minoxidil fluocinolone acetonide hyperkeratotic plaques erythema urea clobetasol terminal hair follicles fibrosis secondary alopecia CCCA Rogaine steroid injections steroid cream

TLDR A woman's severe hair loss was caused by scalp psoriasis, not the initially thought condition, and treatment improved her psoriasis but couldn't restore her lost hair.

The document discusses a rare case of a 50-year-old female with a multi-year history of hair loss initially thought to be due to central centrifugal cicatricial alopecia (CCCA) but later diagnosed as scalp psoriasis. Despite scalp psoriasis being a common condition, it seldom presents as severe alopecia. The patient had previously undergone treatments with intralesional steroid injections, minoxidil, and fluocinolone acetonide with only mild improvements. Upon reevaluation after a two-year absence from the clinic, she presented with hyperkeratotic plaques with erythema on the scalp and frontal hairline. A biopsy confirmed psoriasis, showing diminished terminal hair follicles and associated fibrosis. Treatment with urea plus clobetasol ointment improved the scalp psoriasis, but the alopecia could not be reversed, although further scarring and secondary alopecia were prevented. The case emphasizes the importance of considering a broader differential diagnosis in recalcitrant hair loss to provide symptomatic relief and prevent disease progression.

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Research cited in this study

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research Psoriatic Alopecia

41 citations, July 2015 in “Clinical and Experimental Dermatology”

Psoriasis can cause temporary or permanent hair loss.

research Psoriatic Scarring Alopecia: A Case Report

14 citations, December 2013 in “Anais Brasileiros De Dermatologia”

A woman with long-term scalp psoriasis developed rare scarring hair loss that didn't fully respond to treatments.

research Psoriasis of the Scalp: Diagnosis and Management

128 citations, January 2001 in “American Journal of Clinical Dermatology”

Coal tar shampoos, salicylic acid, and topical corticosteroids are effective for scalp psoriasis, with Vitamin D3 analogues also showing benefits; severe cases may require stronger medication with more risks.

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community I am a dermatologist with a clinical interest in alopecia. AMA

in Will treatment work for me? 2 years ago

In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

community Diffuse hair loss and scalp biopsies

in Research 692 upvotes 3 months ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

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

in Treatment 4 upvotes 5 years ago

Derma rolling, pumpkin seed oil, and daily massages helped regrow weak hairs on the crown. Nizoral shampoo and yoga also contributed to reducing scalp pain and stress.

community Finasteride doesn't work for me in 2 years and my bloodtest result just came in.

in Progress Pictures 88 upvotes 1 year ago

A user has been treating hair loss with finasteride for two years without success and is experiencing an itchy scalp with seborrhea. Despite low DHT levels, they are still losing hair, suggesting that DHT might not be the main cause of their hair loss, and they are considering other treatments or causes.

community Exploring Bryan Johnson's Hair Routine In Detail

in Research/Science 65 upvotes 10 months ago

Bryan Johnson uses a custom hair loss treatment that includes topical finasteride, minoxidil, azelaic acid, diclofenac, tea tree oil, rosemary oil, ginkgo biloba, biotin, and melatonin, which have shown varying degrees of effectiveness with minimal side effects. He also undergoes PRP and laser therapy, and has tried dutasteride mesotherapy.

community lost my hair in a single year of treatment at 20 years old

in Finasteride/Dutasteride 90 upvotes 3 months ago

A 20-year-old lost significant hair after one year of treatment, using minoxidil, finasteride, and later dutasteride. They are considering adding RU58841 but are advised to return to finasteride and minoxidil for a year before deciding.

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Sisaipho Alopecia Areata Treated With Tofacitinib and Oral Minoxidil

research The Changing Patterns of Hair Density and Thickness in South Korean Women with Hair Loss: Clinical Office-Based Phototrichogram Analysis

41 citations, December 2008 in “International Journal of Dermatology”

South Korean women with hair loss have lower hair density and thickness compared to healthy women.