Cicatricial alopecias (scarring alopecias) encompass a diverse group of inflammatory disorders that cause permanent destruction of the pilosebaceous unit and irreversible hair loss. They may be primary or secondary. In the primary group, the hair follicle is the target of a folliculocentric inflammatory attack that results in replacement of the follicle with fibrous tissue.
The secondary scarring alopecias are the result of a non-folliculocentric process or external injury; follicular destruction is secondary and incidental, as in severe infections (kerion), infiltrations (tumors, metastatic cancer, sarcoid), physical injuries (thermal burns, radiation, traction). In this monograph, the focus is on the primary scarring alopecias.
This book is a richly-illustrated and practical text that would be a teaching vehicle primarily for dermatology residents and interested dermatology colleagues. Each disease chapter is introduced with a clinical scenario of a patient, along with relevant clues for making the diagnosis.
The discussion section follows and includes multiple photographs and take-away pearls to provide practical information needed to diagnose, manage, and counsel the patient. The suggested reading is not meant to be an exhaustive literature review, but rather a list of a few salient references. The voices of the patients can be heard in the chapter written by patients who tell of their frustrations in being undiagnosed by doctor after doctor, and untreated or mistreated for years.
The goal is to put the cicatricial alopecias on the center stage for dermatology residents and colleagues, because dermatologists may be the only physicians who can diagnose and treat these patients.
1 Introduction
- How Are the Cicatricial Alopecias Classified?
- What Are the Demographics of Patients with Cicatricial Alopecia?
- Why Is Hair Loss in Cicatricial Alopecia Irreversible?
- If Time Is Limited On the Initial Visit, Take the Scalp Biopsy On the First Visit, and Complete the Evaluation at Next Visit
- Scalp Biopsy
- Evaluation of the Patient
- History
- Examination
- Standardized Patient Flow Chart
- Lymphocyte-Mediated Primary Cicatricial Alopecias
- Neutrophil-Mediated Primary Cicatricial Alopecias
- Mixed Cicatricial Alopecia
- Choice of Treatment
- Counseling and Setting Expectations
- Treatment of Predominantly Lymphocytic Cicatricial Alopecia
- Treatment of Predominantly Neutrophilic / Plasmacytic Cicatricial Alopecia
- Laboratory Workup and Side Effects of Systemic Drugs
- Confounding Factors in Managing Cicatricial Alopecias
- Overview
- Animal Models and the Sebotrophic Hypothesis
- Stem Cells and Immunology
- Lipid Metabolic Pathways and Peroxisomes
- Future Areas of Research and Unanswered Questions/Controversies
- Lichen Planopilaris
- Graham Little Syndrome
- Frontal Fibrosing Alopecia
- Pseudopelade (Brocq)
- Central Centrifugal Cicatricial Alopecia
- Chronic Cutaneous Lupus Erythematosus
- Keratosis Follicularis Spinulosa Decalvans
- Folliculitis Decalvans
- Tufted Folliculiti
- Dissecting Cellulitis
- Folliculitis Keloidalis
- Clinical Scenario
- Making the Diagnosis
- History
- Exam
- Scalp Biopsy
- Understanding and Helping Patients with Cicatricial Alopecia
- On Fire for Research and a Cure!
- Cicatricial Alopecia Needs You!
- Looking in the Mirror
- My Hair Loss Encounter
- Looking for Answers
- My CICAL Journal
- A Call to Action: When in Doubt, Biopsy
Book Details
- Hardcover: 102 pages
- Publisher: Springer; 1st edition (June 1, 2011)
- Language: English
- ISBN-10: 1441983988
- ISBN-13: 978-1441983985