Continuing medical educationPrimary cicatricial alopecia: Lymphocytic primary cicatricial alopecias, including chronic cutaneous lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia, and Graham-Little syndrome
Section snippets
Introduction and general assessment
Key points Hair loss may progress subclinically Diagnosis is often delayed All hair-bearing areas should be examined Perifollicular accentuation and isolated hairs are precious clues Unless there is a true primary infection, cultures are usually negative in patients with primary cicatricial alopecia Laboratory testing should be performed in accordance with the clinical setting
Primary cicatricial alopecias (PCAs) represent a group of poorly understood conditions in which the destruction of follicular structures
General management of primary cicatricial alopecia
Key points Evidence supporting therapy is generally poor The aims of treatment are to stop or reduce hair loss, control the symptoms, and reduce the clinical signs of inflammation. Regrowth should not be expected Choice of therapy is guided by the type of inflammatory infiltrate Duration of therapy is guided by the response and relapse rate No evidence supports the use of most over the counter products and shampoos Potent corticosteroids and intralesional triamcinolone acetonide are commonly used in all forms
Chronic cutaneous lupus erythematosus
Key points Signs and symptoms of systemic lupus erythematosus must be excluded Chronic cutaneous lupus erythematosus of the scalp usually responds well to therapy
Chronic cutaneous lupus erythematosus (CCLE) is more common in white and African American women.103, 104, 105 It may occur at any age, but predominantly occurs between 20 and 40 years of age.105, 106, 107 Solitary or multiple variable size lesions occur primarily on sun-exposed areas and on the scalp103, 106, 108, 109, 110 (Fig 4). They consist of
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Diagnosis and treatment of scarring alopecia
2023, Procedures in Cosmetic Dermatology: Hair RestorationMedical workup for hair loss
2023, Procedures in Cosmetic Dermatology: Hair RestorationAdvances in microneedles research based on promoting hair regrowth
2023, Journal of Controlled ReleaseReversible hair loss in a patient with cicatricial alopecia: A case of regrowth associated with pioglitazone use
2022, JAAD Case ReportsCitation Excerpt :Auxillary therapies including low-dose oral minoxidil can be utilized to increase the thickness of unaffected hair and conceal adjacent alopecic areas.3 Hair regrowth is unexpected during the course of treatment due to the conditions’ permanent destruction of multipotent follicular stem cells.4 Rare cases of hair regrowth in patients with cicatricial alopecia have been sporadically reported.1
Immune-mediated alopecias and their mechanobiological aspects
2022, Cells and DevelopmentCitation Excerpt :This perspective will focus on the immune-mediated aspects of major subtypes of alopecia, including a discussion of non-cicatricial AA as well as primary cicatricial alopecias. Cicatricial alopecias are categorized as primary and secondary forms (Bolduc et al., 2016). This discussion will focus on primary forms of cicatricial alopecia, in which the hair follicle is sole target due disease pathology.
Dr Bolduc has been a speaker for Johnson and Johnson. Dr Shapiro has been a speaker for, consultant for, or has received honoraria from Merck, Johnson and Johnson, Dr Reddy, and Applied Biology. He is the founder of, has stock options in, and is a shareholder for Replicel. Dr Sperling has no conflicts of interest to declare.
Date of release: December 2016
Expiration date: December 2019