Central centrifugal scarring alopecia L66.8

Central centrifugal scarring alopecia is an aetiologically unexplained inflammatory follicular atrophying disease of the capillitium which occurs predominantly in women of African descent. The disease was previously also known as hot comb alopecia (LoPresti P et al. 1968) or as "follicular degeneration syndrome" (see Blattner C et al. 2013).

A multifactorial etiology is discussed. Controversially, a genetic disposition, the frequent use of smoothing agents, bacterial or mycotic infections are controversially discussed with regard to a causal relationship.

Middle and advanced age

Scarring alopecia in the vertex area of the capillitium as a result of chronic inflammation of unknown etiology. In the course of the disease, a slow, often symmetrical peripheral spread becomes apparent. Perifollicular erythema and hyperpigmentation, polytrichia (fused infundibula) and islets of unaffected skin are found (Kanti V et al. 2018).

Perifollicular lymphocytic infiltrate, loss of the inner root sheath.

Topical or intralesional glucocorticoids.

Systemic: Doxycycline, oral glucocorticoids, hydroxychloroquine, ciclosporin.

1. Blattner C et al (2013) Central centrifugal cicatricial alopecia. Indian Dermatol Online J 4:50-51.
2. Gathers RC et al (2009) Central centrifugal cicatricial alopecia: past, present, and future. J Am Acad Dermatol 60:660-668.
3. Kanti V et al (2018) Cicatricial alopecia. JDDg 16: 435-4611
4. LoPresti P et al (1968) Hot comb alopecia. Arch Dermatol 98:234-238.
5. Ogunleye TA et al (2014) Central centrifugal cicatricial alopecia: what has been achieved, current clues for future research. Dermatol Clin 32:173-181.
6. Olsen EA et al (2011) Central hair loss in African American women: incidence and potential risk factors. J Am Acad Dermatol 64:245-252.