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finding that describes the diagnosis of some primary cicatricial alopecias as noted mainly in the central scalp, and includes CCCA, folliculitis decalvans, and any other potential centrally presenting cicatricial alopecia. This term is not often used in the literature to signify diagnostic terminology.
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The mechanism of pathology of CCCA remains unknown; thus, the cause has only been postulated and not proven. CCCA is suspected to have a multi-factored cause. However, one theory involves pressure exerted on the internal root sheath leading to damage, which leads to the recruitment of inflammatory
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A similarly sounding term is central centrifugal scarring alopecia (CCSA). (L.C. Sperling, Central, centrifugal scarring alopecia. In: L.C. Sperling, Editor, An atlas of hair pathology with clinical correlations, Parthenon
Publishing Group, New York (2003), pp. 91–100). This is a clinical
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followed by a stove-heated iron comb. The original theory was that the hot petrolatum would travel down to the hair root, burn the follicle, and after repetitive injury scarring would result. Later CCCA was realized to affect men and women without a history significant for use of such styling
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techniques. Consequently, the terms "follicular degeneration syndrome" per
Sperling and Sau in 1992 and then CCCA per Olsent et al. in 2003 were evolved. Plausible contributing factors may include other African-American styling techniques such as
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The terminology of CCCA has been a source of regular confusion. Recent clarifications have been made, with the term "central centrifugal cicatritial alopecia" adopted as a diagnostic category by the
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Type VI or VII. Early symptoms may include pruritus, dysesthesias and tenderness. On examination the skin is thin with few follicular ostia and later in the disease the scalp may appear shiny.
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Treatments for CCCA remain investigational. Altering hair care practices has not been proven to assist in hair rejuvenation. High-dose topical steroids, antibiotics, immunomodulators such as
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CCCA usually begins at the central (sagittal) midline of the scalp. It is symmetric and exhibits scarring as the name suggests. It involves solely the top of the scalp or may progress to
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CCCA tends to present itself in the 20s and progresses over 20–30 years. One should consider this diagnosis in
African Americans with what appears to be a female-pattern hair loss.
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cells and the result of scarring. African
Americans are found to be at increased risk. Historically, some have hypothesized that CCCA represents an end stage of
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Also in this category is cicatricial pattern hair loss (CPHL). This CCCA pattern is a potential alopecia mimic that can be confused for
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Androgenic pattern presentation of scarring and inflammatory alopecia. J Eur Acad
Dermatol Venereol. 2010 Jan 6. Rashid RM, Thomas V.
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112:. However, the veracity of this theory is low as many patients who have CCCA have not employed traction hairstyling.
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205:. Alopecia mimics have proven a problem in establishing diagnosis of alopecia when using only clinical evaluation.
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Wang EH, Monga I, Sallee BN, Chen JC, Abdelaziz AR, Perez-Lorenzo R, Bordone LA, Christiano AM (Jul 2022).
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273:"Primary cicatricial alopecias are characterized by dysregulation of shared gene expression pathways"
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Female
Pattern Hair Loss and its Relationship to Permanent/Cicatricial Alopecia: A New Perspective.
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164:(Elidel), and anti-androgen/5alpha Reductase inhibitors have been used with unknown efficacy.
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in the 1950s and reported by LoPresti et al. in 1968 as a result of application of
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loss and premature disintegration of the internal root sheath. Additionally,
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Ross EK, Tan E, Shapiro J. J Am Acad
Dermatol. 2005 Jul;53(1):1-37;
87:, tight braids, heavy extensions, certain oils, gels or pomades.
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secondary to follicular rupture has been noted. Perifollicular
401:. North American Hair Research Society. Archived from
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James, William; Berger, Timothy; Elston, Dirk (2005).
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51:
37:
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120:Histopathologic features include a perifollicular
330:Fitzpatrick's Dermatology in General Medicine
197:Central elliptical pseudopelade in Caucasians
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64:Central centrifugal cicatricial alopecia
33:Central centrifugal cicatricial alopecia
258:www.Skinandaging.com, volume 11. (2003)
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266:
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256:Central Centrigugal Scarring Alopecia.
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372:Journal of Investigative Dermatology
182:North American Hair Research Society
184:. It has also been referred to as:
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439:Conditions of the skin appendages
194:Pseudopelade in African Americans
191:Follicular degeneration syndrome
124:infiltrate, concentric lamellar
46:Follicular degeneration syndrome
18:Follicular degeneration syndrome
1:
397:Dirk M. Elston; Elise Olsen.
224:List of cutaneous conditions
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332:. (6th ed.). McGraw-Hill.
328:Freedberg, et al. (2003).
138:granulomatous inflammation
132:in the papillary dermis),
289:10.1093/pnasnexus/pgac111
353:. (10th ed.). Saunders.
254:Woolery-lloyd, Heather.
116:Histopathologic features
399:"Cicatricial Alopecia"
319:Sperling and Sau, 1992
97:Hamilton–Norwood scale
203:androgenetic alopecia
219:Cicatricial alopecia
146:follicular keratosis
148:is usually absent.
188:Hot comb alopecia
110:traction alopecia
76:African Americans
74:first noticed in
61:
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42:Hot comb alopecia
27:Medical condition
16:(Redirected from
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160:(Protopic) and
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134:sebaceous gland
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283:(3): pgac111.
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407:. Retrieved
403:the original
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168:Epidemiology
162:pimecrolimus
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91:Presentation
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378:, 1827-1828
176:Terminology
130:fibroblasts
128:(layers of
122:lymphocytic
57:Dermatology
38:Other names
433:Categories
409:2010-06-24
277:PNAS Nexus
235:References
158:tacrolimus
80:petrolatum
444:Syndromes
152:Treatment
53:Specialty
307:35899069
229:Hot comb
213:See also
142:erythema
126:fibrosis
85:relaxers
72:alopecia
374:(2007)
298:9308563
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103:Cause
355:ISBN
334:ISBN
303:PMID
144:and
68:CCCA
44:and
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293:PMC
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Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.