Keywords: Dermoscopy, lichen planopilaris (LPP), discoid lupus erythematosus (DLE), pseudopelade of brocq (PB).
In this observational study, we included 18 patients irrespective of age and gender with clinically and histopathologically confirmed cases of lichen planopilaris (LPP), discoid lupus erythematosus (DLE), pseudopelade of Brocq (PB).
The number of hair is characteristically reduced in scarring alopecia and may range from total absent hair in pseudopelade of Brocq.
Classification of cicatricial alopecia Lymphocytic (i) Discoid lesions of lupus erythematosus (ii) Lichen planopilaris (a) Classic LPP (b) Frontal fibrosing alopecia (c) Graham Little syndrome (iii) Pseudopelade
of Brocq (iv) Central centrifugal cicatricial alopecia (v)Alopecia mucinosa (vi) Keratosis follicularis spinulosa decalvans Neutrophilic (i) Folliculitis decalvans (ii) Dissecting cellulitis Mixed cell (i) Acne keloidalis (ii) Acne necrotica (iii) Erosive pustular dermatosis Table 2: Peroxisome proliferator-activated receptors (PPARs) in human skin.
Differentiating between pseudopelade
of Brocq and scarring classic LPP can be challenging as they both have multifocal involvement of the vertex scalp although LPP presents more frequently with perifollicular erythema and follicular keratotic plugs than pseudopelade
of Brocq [43,114].
Right from common hair disorders like hair loss, dandruff and baldness to uncommon diseases of the hair and scalp like alopecia, pseudopelade
, lichen planus, trichotillomania and others.
Evaluation of inflammatory infiltrate and fibrogenic cytokines in pseudopelade
of Brocq suggests the involvement of T-helper 2 and 3 cytokines.
DiscussionCentral centrifugal cicatricial alopecia (CCCA) is the term adopted by the North American hair research society (NAHRS) to encompass the previous terms of hot comb alopecia" follicular degeneration syndrome" pseudopelade
" in African Americans and central elliptical pseudopelade
Results In our study, major causes of cicatricial alopecia were lichen planopilaris (27.5%), discoid lupus erythematosus (25%), pseudopelade of Brocq (20%), systemic lupus erythematosus (5%) followed by scleroderma, dermatomyositis, keratosis follicularis spinulosa decalvans, aplasia cutis, kerion, follicular mucinosis, pemphigus, dissecting cellulitis of scalp/ pyogenic folliculitis and acne keloidalis nuchae in 2.5% cases each.
Lichen planopilaris, discoid lupus erythematosus, pseudopelade of Brock were the common causes of cicatricial alopecia in the studied population.
In primary cicatricial alopecia, the hair follicle is the target of inflammatory destruction, with little effect of the disease process on other components of the dermis.2 Examples of primary alopecia include discoid lupus erythematosus, lichen planopilaris, central centrifugal cicatricial alopecia, pseudopelade of Brocq, folliculitis decalvans, and acne keloidalis.3,4 In secondary cicatricial alopecia, the hair follicle is an "innocent bystander" and is destroyed indirectly.
A few entities in scarring alopecia are lichen planopilaris, central centrifugal cicatricial alopecia, pseudopelade
, discoid lupus erythematosus and traction alopecia.