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Year : 2012  |  Volume : 1  |  Issue : 1  |  Page : 21-26

Clinico-pathological study of acquired primary cicatricial alopecias

1 Department of DVL, Andhra Medical College, King George Hospital, Visakhapatnam, Andhra Pradesh, India
2 Department of Dermatology, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India

Correspondence Address:
T Narayana Rao
Professor of Dermatology, Department of DVL, King George Hospital, Visakhapatnam, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2277-8632.94171

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Background: Alopecias are classified into non-scarring and scarring/cicatricial alopecias. Cicatricial alopecias represent a diverse group of diseases characterized by a lack of follicular ostia and irreversible alopecia. The main purpose of hair revolves around its profound role in social interactions. Loss of hair can lead to significant psychological and emotional distress. Hence, an accurate and early diagnosis and prompt intervention are necessary to prevent further follicular destruction. Objective: To evaluate the epidemiological, clinical, and histopathological characteristics of various acquired primary cicatricial alopecias. Materials and Methods: The study population consists of 50 patients with acquired primary cicatricial alopecias seen in our Dermatology Outpatient Department, during the period from September 2008 to September 2010. Results: The most prevalent diagnoses in order of frequency lichen planopilaris (LPP, 50%), discoid lupus erythematosus (DLE, 20%), and pseudopelade of Brocq (POB, 12%). The ratio of lymphocytic to neutrophilic cicatricial alopecias was 7.3:1. A female predominance of lymphocytic cicatricial alopecias was observed. Both LPP and DLE affected predominantly middle-aged adults. Conclusion: LPP and DLE followed by pseudopelade were the common cicatricial alopecias. In contrast to the previous large-scale studies, which showed DLE and/or pseudopelade as the foremost diagnosis, LPP is the most frequent cause of adult primary scarring alopecia in our study. An accurate diagnosis of cicatricial alopecia can be achieved only through careful clinicopathologic evaluation. Early scalp biopsy is mandatory in all cases. Further large-scale studies are necessary to establish a cause and pathogenesis behind this increased prevalence of LPP in our setting when compared to the western population.

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