Primary cicatricial alopecias: clinicopathology of 112 cases.
BACKGROUND
Cicatricial alopecias represent a diverse group of diseases characterized by a lack of follicular ostia and irreversible alopecia. There is limited literature on the epidemiology and therapeutics of cicatricial alopecias.


OBJECTIVE
The aim of this study was to review the epidemiology, clinical characteristics, and treatment of inflammatory cicatricial alopecias in a mixed ethnic population referred to a university hair clinic.


METHODS
The study population consisted of 112 patients seen during a 5-year period with acquired primary cicatricial alopecias. This represented 3.2% of the total number of trichologic consultations seen at the University of British Columbia Hair Clinic, Vancouver, British Columbia, Canada.


RESULTS
The ratio of lymphocytic to neutrophilic cicatricial alopecias was 4:1. Lymphocytic cicatricial alopecias had a tendency to affect middle-aged women, whereas neutrophilic cicatricial alopecias had a predilection for middle-aged men.


CONCLUSIONS
An accurate diagnosis of cicatricial alopecia is achieved through careful clinicopathologic evaluation. We suggest that a scalp biopsy is mandatory in all cases. Multiple biopsies may be necessary for some affected individuals to achieve a definitive diagnosis as a result of a highly variable clinical course. An aggressive multiple modality therapeutic approach is often necessary to prevent further irreversible follicular destruction, implying cicatrical alopecia should be considered a trichologic emergency. Current therapeutic options for lymphocytic cicatricial alopecia include corticosteroids, antimalarials, and isotretinoin versus antibiotics, corticosteroids, and isotretinoin for neutrophilic cicatricial alopecias.
Tan
Eileen
E
Division of Dermatology, University of British Columbia, Vancouver General Hospital, Canada.
Martinka
Magdalena
M
Ball
Nigel
N
Shapiro
Jerry
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000505:Alopecia / Q000145:classification / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000145:classification / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged