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 |
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)
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