title: Pathologic diagnosis of central centrifugal cicatricial alopecia on horizontal sections.
abstract: The pathologic findings in Central Centrifugal Cicatricial Alopecia (CCCA) have not been studied systematically in horizontal sections. Our objective was to establish the pathologic features, and their frequency in horizontal sections of scalp biopsies obtained from patients with clinically and histologically proven CCCA. Serial horizontal sections of 51 cases were evaluated retrospectively. All biopsies were assessed at 4 levels and at least on 24 horizontal sections. The most common pathologic findings were follicular miniaturization (81% of the cases); premature desquamation of the inner root sheath (96%), focal preservation of the sebaceous glands (94%), which in most of these cases appeared as surrounding "in a hug" an intact vellus follicle; compound follicular structures with perifollicular fibrosis and/or inflammation (89%), lamellar hyperkeratosis/parakeratosis in the hair canal (79%), absent or mild inflammation (77%), and naked hair shafts (68%). Horizontal sections are useful in CCCA to identify early or focal disease and to provide the clinician with better information on the presence of follicular miniaturization, inflammation, and scarring, which can be used to tailor the treatment to the individual patient.
authors.affiliation: Assistant Professor of Dermatology (Dr Miteva), and Professor of Dermatology (Dr Tosti), Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Mariya
authors.initials: M
authors.lastname: Miteva
authors.forename: Antonella
authors.initials: A
authors.lastname: Tosti
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000505:Alopecia / Q000208:ethnology / Q000473:pathology*; D001706:Biopsy; D002921:Cicatrix / Q000208:ethnology / Q000473:pathology*; D005260:Female; D018859:Hair Follicle / Q000473:pathology; D006801:Humans; D008867:Microtomy / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012535:Scalp / Q000473:pathology*; D012627:Sebaceous Glands / Q000473:pathology; D013194:Staining and Labeling; D055815:Young Adult