Introduction:Scarring and non-scarring alopecias have rarely been described to occur together in the same patient.Distinguishing these two different types of alopecia is important as treatment and prognosis can be dif...Introduction:Scarring and non-scarring alopecias have rarely been described to occur together in the same patient.Distinguishing these two different types of alopecia is important as treatment and prognosis can be different.Case presentation:Here,we report the first case of simultaneous alopecia areata(AA)and central centrifugal cicatricial alopecia(CCCA)in a 35-year-old woman.New alopecic patches were noted on her frontal and vertex scalp.Biopsy of the frontal scalp revealed miniaturized hair follicles and dense lymphocytic infiltrate surrounding the hair bulbs,consistent with AA;while biopsy of the vertex scalp revealed decreased hair follicles,perifollicular fibroplasia with eccentric atrophy of the follicular epithelium,and premature desquamation of the inner root sheath at the level of the lower isthmus,consistent with CCCA.Discussion:Proposed mechanisms of these two alopecia types occurring together include loss of immune privilege,genetic predisposition,as well as unknown external factors that trigger an autoimmune lymphocytic response.Most recently,the peptidylarginine deiminase type III gene has been implicated in both diseases.Although treatment options can overlap between thetwo diseases,treatment response can differ and CCCA tendsto have a worse prognosis.Conclusion:Awareness of this concomitant presentation of two alopecic types is important for appropriate treatment and prognostication.展开更多
Frontal fibrosing alopecia(FFA) is a recently described form of primary cicatricial alopecia, characterized by progressive recession of the frontotemporal hairline and eyebrow loss, occurring predominantly in postmeno...Frontal fibrosing alopecia(FFA) is a recently described form of primary cicatricial alopecia, characterized by progressive recession of the frontotemporal hairline and eyebrow loss, occurring predominantly in postmenopausal women. The incidence of FFA has increased significantly during the last decade and we may be facing an epidemic of the disease. Because this condition causes permanent hair loss, prompt diagnosis and treatment are essential for obtaining optimal outcome. This article reviews existing knowledge on epidemiology, etiopathogenesis, clinico-histological features, diagnosis,and treatment modalities of FFA.展开更多
Background: Scarring alopecia like discoid lupus erythematosus, lichenplanopilaris and scarring folliculitis are common skin problems where differentiations between them are often difficult in many cases. Objective: T...Background: Scarring alopecia like discoid lupus erythematosus, lichenplanopilaris and scarring folliculitis are common skin problems where differentiations between them are often difficult in many cases. Objective: To report, study and evaluate cases of lichen planopilaris and characterize the different clinical points in favor of this disease. Patients and Methods: This case series descriptive study was done at Department of Dermatology-Baghdad Teaching Hospital from January 2010 to November 2012. Sixty seven patients were included where histological and dermatological examinations were carried out to all patients regarding all relevant points related to the disease. Punch biopsies were performed from ten patients for histopathological study. Results: The mean age of onset of the disease was 36.7 ± 5 years with a mean duration of the disease being 4.4 ± 3 years. The male to female ratio was 1.4:1. The characteristic lesions were pigmented scarring moth eaten alopecia surrounded by pigmented hyperkeratotic follicular papules involving mainly the fronto-vertical and parietal scalp. Conclusions: Lichen planopilaris is a common cause of scalp scarring alopecia in adult and it has many characteristic clinical features which can facilitate differentiation from other pathologic scalp conditions like discoid lupus erythematosus.展开更多
文摘Introduction:Scarring and non-scarring alopecias have rarely been described to occur together in the same patient.Distinguishing these two different types of alopecia is important as treatment and prognosis can be different.Case presentation:Here,we report the first case of simultaneous alopecia areata(AA)and central centrifugal cicatricial alopecia(CCCA)in a 35-year-old woman.New alopecic patches were noted on her frontal and vertex scalp.Biopsy of the frontal scalp revealed miniaturized hair follicles and dense lymphocytic infiltrate surrounding the hair bulbs,consistent with AA;while biopsy of the vertex scalp revealed decreased hair follicles,perifollicular fibroplasia with eccentric atrophy of the follicular epithelium,and premature desquamation of the inner root sheath at the level of the lower isthmus,consistent with CCCA.Discussion:Proposed mechanisms of these two alopecia types occurring together include loss of immune privilege,genetic predisposition,as well as unknown external factors that trigger an autoimmune lymphocytic response.Most recently,the peptidylarginine deiminase type III gene has been implicated in both diseases.Although treatment options can overlap between thetwo diseases,treatment response can differ and CCCA tendsto have a worse prognosis.Conclusion:Awareness of this concomitant presentation of two alopecic types is important for appropriate treatment and prognostication.
文摘Frontal fibrosing alopecia(FFA) is a recently described form of primary cicatricial alopecia, characterized by progressive recession of the frontotemporal hairline and eyebrow loss, occurring predominantly in postmenopausal women. The incidence of FFA has increased significantly during the last decade and we may be facing an epidemic of the disease. Because this condition causes permanent hair loss, prompt diagnosis and treatment are essential for obtaining optimal outcome. This article reviews existing knowledge on epidemiology, etiopathogenesis, clinico-histological features, diagnosis,and treatment modalities of FFA.
文摘Background: Scarring alopecia like discoid lupus erythematosus, lichenplanopilaris and scarring folliculitis are common skin problems where differentiations between them are often difficult in many cases. Objective: To report, study and evaluate cases of lichen planopilaris and characterize the different clinical points in favor of this disease. Patients and Methods: This case series descriptive study was done at Department of Dermatology-Baghdad Teaching Hospital from January 2010 to November 2012. Sixty seven patients were included where histological and dermatological examinations were carried out to all patients regarding all relevant points related to the disease. Punch biopsies were performed from ten patients for histopathological study. Results: The mean age of onset of the disease was 36.7 ± 5 years with a mean duration of the disease being 4.4 ± 3 years. The male to female ratio was 1.4:1. The characteristic lesions were pigmented scarring moth eaten alopecia surrounded by pigmented hyperkeratotic follicular papules involving mainly the fronto-vertical and parietal scalp. Conclusions: Lichen planopilaris is a common cause of scalp scarring alopecia in adult and it has many characteristic clinical features which can facilitate differentiation from other pathologic scalp conditions like discoid lupus erythematosus.
