Scarring alopecias

Figure 3.52 A: Acquired triangular alopecia (Courtesy of Dr. Iris K. Aronson) B: Central centrifugal alopecia* C: Lichen planopilaris* *Courtesy of Dr. Sophie M. Worobec
Figure 3.52
A: Acquired triangular alopecia
(Courtesy of Dr. Iris K.
Aronson
)
B: Central centrifugal alopecia*
C: Lichen planopilaris*
*Courtesy of Dr. Sophie M.
Worobec
Central Centrifugal Cicatricial Alopecia (Hot Comb Alopecia) (Figure 3.52B)
  • Also known as follicular degeneration syndrome, pseudopelade of the central scalp, and folliculitis decalvans of the central scalp and vertex
  • Scarring alopecia typically in African American women thought to be due to chemicals or heat leading to premature desquamation of inner root sheath
  • Presents as alopecic ill-defined areas with scarring over crown or vertex with gradual expansion; inflammation might not be appreciated
  • Histology: concentric lamellar fibroplasia of involved follicles, perifollicular inflammation, fragments of hair shaft and granulomatous inflammation (advanced cases)
  • Treatment: high potency topical corticosteroid ± oral antibiotic (tetracycline family, i.e. doxycycline)