Clinical features of primary cicatricial alopecia in Chinese patients.
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Date
2014-07
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Abstract
Background: There have been few reports on primary cicatricial alopecias (PCR) especially from
Asia (PCA). Aims: To study the clinical, pathological and dermoscopic characteristics of PCA
among Chinese patients. Methods: A retrospective analysis of the clinical data of 59 patients with
PCA was conducted and the dermoscopic, pathological, treatment and prognosis characteristics
analyzed. Fisher’s Chi‑square exact test, Kruskal‑Wallis and Spearman rank correlation test
were performed. Results: The ratio of neutrophilic to lymphocytic cicatricial alopecias was about
1.3:1 in this group. The most frequent disorder was folliculitis decalvans. Follicular openings were
absent on dermoscopy in all cases except alopecia mucinosa. Patulous follicular openings were
characterisitc of alopecia mucinosa. After treatment, an increase in short vellus hairs was the
earliest feature, while telangiectasia, epidermal scale, follicular hyperkeratosis, pustules and hair
diameter diversity gradually decreased or even disappeared. Improvement in the areas of hair
loss after treatment was seen more often in discoid lupus erythematosus, folliculitis decalvans
and dissecting cellulitis than in patients with classic pseudopelade of Brocq. Nine patients (13.6%)
relapsed after cessation of therapy. Female patients needed longer treatment times. Long
duration, large areas of hair loss and shorter treatment courses were the major factors in relapses.
Conclusions: Dermatoscopy provides a rapid, practical and useful aid for the diagnosis of PCA
and also to assess disease activity. Patulous follicular openings are a specific dermoscopic sign
of alopecia mucinosa. Lichen planopilaris is less common in China than in the West.
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Keywords
Cicatricial/scarring alopecia, clinical features, dermoscopy, pathology
Citation
Qi Shiling, Zhao Ying, Zhang Xiaoting, Li Shuifeng, Cao Hui, Zhang Xingqi. Clinical features of primary cicatricial alopecia in Chinese patients. Indian Journal of Dermatology, Venereology and Leprology. 2014 Jul-Aug; 80(4): 306-312.