Central centrifugal cicatricial alopecia


Central centrifugal cicatricial alopecia

Also ref2242ed to as hot comb alopecia and follicular degeneration syndrome.

CCCA is the most common type of primary scarring alopecia affecting women of African ancestry.

Presents in the 20s and progresses over 20–30 years.

Considered diagnosis in African Americans with what appears to be a female-pattern hair loss.

CCCA usually begins at the central midline of the scalp.

Unexplained hair breakage may be an early sign.

Hair breakage is then followed by hair thinning, mostly involving the scalp vertex.

CCCA hair loss progresses centrifugally.

Most patients present with a process resembling androgenetic alopecia.

It is symmetric and exhibits scarring.

Involves solely the top of the scalp.

Early symptoms may include pruritus, dysesthesias and tenderness, and on examination the skin is thin with few follicular ostia and later in the disease the scalp may appear shiny.

It can affect men and women without a history significant for use of such styling techniques.

Histopathologic findings includeblymphocytic inflammation, follicular degeneration, and fibrosis.

Prevalence estimated to vary from 2.7-5.6% among women of African ancestry,

The mean age a presentation is 36 years.

Familiar occurrence is suspected to be inherited as an autosomal dominant susceptible manner.

Mutations in PAD13, which includes a protein that is essential to proper hair-shaft formation is associated with CCCA.

The pathophysiology postulated involves pressure on the internal root sheath which leads to damage, that leads to the recruitment of inflammatory cells and the end result is scarring.

African Americans are found to be at increased risk either because of the curled hair shaft, distinct styling practices, moisturizing hair products, or chemical processing techniques.

Histopathologic features include: perifollicular lymphocytic infiltrate, concentric lamellar fibrosis, sebaceous gland loss, premature disintegration of the internal root sheath, and granulomatous inflammation secondary to follicular rupture has been noted.

No successful treatments for CCCA exists.

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