Association of type 2 diabetes with central centrifugal cicatricial alopecia: A follow-up study

Roche, Fritzlaine C.; Harris, Jasmine; Ogunleye, Temitayo; Taylor, Susan C.

doi:10.1016/j.jaad.2021.02.036

Cited by 10 publications

(7 citation statements)

References 6 publications

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“…An association between hypertension and CCCA was recently reported, though the sample size was small (22 patients) 85 . Roche et al found that the odds of nonobese women with biopsy‐proven CCCA having type 2 DM are four times those of healthy controls (OR: 4.13; 95% CI: 2.76–6.18), in concordance with prior studies that have supported an association between CCCA and DM 91–93 . Another retrospective review of biopsy‐proven CCCA patients demonstrated an association between CCCA and hyperlipidemia but found no statistically significant associations between CCCA and hypertension or diabetes 94 .…”

Section: Scarring Alopeciasmentioning

confidence: 60%

“…85 Roche et al found that the odds of nonobese women with biopsy-proven CCCA having type 2 DM are four times those of healthy controls (OR: 4.13; 95% CI: 2.76-6.18), in concordance with prior studies that have supported an association between CCCA and DM. [91][92][93] Another retrospective review of biopsy-proven CCCA patients demonstrated an association between CCCA and hyperlipidemia but found no statistically significant associations between CCCA and hypertension or diabetes. 94 Gene expression pathway analysis has shown that the greatest overlap between CCCA and other FPDs is with atherosclerosis.…”

Section: Central Centrifugal Cicatricial Alopecia (Ccca)mentioning

confidence: 99%

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Cardiovascular risk in patients with scarring and nonscarring alopecias: Assessing the current state of evidence

Sally,

Robinson,

Orlow

et al. 2023

JEADV Clinical Practice

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Alopecia is traditionally classified into scarring and nonscarring subtypes, with etiopathologies ranging from androgen‐mediated to immuno‐inflammatory. Over 50% of men and almost 50% of women will experience some form of hair loss in their lifetime. Given this prevalence and the psychosocial significance of hair, understanding the pathophysiology and comorbidities of different types of hair loss is imperative. Other proinflammatory dermatologic disorders, such as psoriasis, are recognised to have systemic manifestations including an increased risk of cardiovascular (CV) disease, and are now considered CV risk‐enhancing conditions. With increased recognition of the importance of systemic inflammation in promoting atherosclerosis, high prevalence, and improved treatment strategies, there is increased interest in establishing whether a similar association between alopecia and cardiovascular disease (CVD) exists. In this manuscript, we aim to review the current literature regarding CV risk in androgenic alopecia (AGA) and alopecia areata (AA). Additionally, we review the literature for cicatricial alopecias and highlight the need for more research into their potential associations with CV risk. Evidence from the identified AGA publications suggests an association of AGA with CV risk factors including hypertension, dyslipidemia, and insulin resistance, as well as with coronary artery disease. For AA, most of the identified studies found an association between AA and CV risk, though the relationships were not always statistically significant. Research on cicatricial alopecias and CV risk is limited and often contradictory. There is great need for more studies regarding the association between various types of alopecia and the development of CVD, and potential mechanisms. Particularly needed are more studies of cicatricial alopecias and potential associated CV risk. While some literature suggests that patients with alopecia have an increased risk of CVD, the lack of concrete evidence represents a notable gap in our current understanding.

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Section: Scarring Alopeciasmentioning

confidence: 60%

Section: Central Centrifugal Cicatricial Alopecia (Ccca)mentioning

confidence: 99%

Cardiovascular risk in patients with scarring and nonscarring alopecias: Assessing the current state of evidence

Sally,

Robinson,

Orlow

et al. 2023

JEADV Clinical Practice

View full text Add to dashboard Cite

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“…Evidence demonstrates that CCCA may be a marker of metabolic dysregulation [7,11,15]. Roche et al demonstrated that nonobese women with biopsy-proven CCCA had over a 3× risk of developing diabetes mellitus type 2 than their age, race and sex-matched controls ((OR (95% CI)): 3.26 (1.33-8.04); p-value < 0.05)) [7].…”

Section: Clinical Associationsmentioning

confidence: 99%

“…The aetiology of CCCA is multifactorial, ranging from genetic predisposition to traumatic hairstyling practices [2]. The association with metabolic syndrome and breast cancer also promotes inquiry into relevant genetic markers and potential public health implications [3][4][5][6][7]. Therefore, a high index of suspicion in the adolescent population should be maintained as there is wide variability in the presentation of CCCA.…”

Section: Introductionmentioning

confidence: 99%

Central Centrifugal Cicatricial Alopecia in the Adolescent Population: An Overview of Available Literature

Palmer

Valdebran

2023

Life

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Central centrifugal cicatricial alopecia (CCCA) is a lymphocytic scarring alopecia that predominantly affects women of African descent. Recent studies have demonstrated prevalence in children and adolescents, as well as Asian populations. A thorough search of Pubmed, Cochrane Database of Systematic Reviews, OVID Medline and Google Scholar was conducted using keywords such as “central centrifugal cicatricial alopecia”, “scarring hair loss”, “scarring alopecia”, “hot comb alopecia”, “pediatric” and “adolescent”. The results yielded few articles in the literature that directly addressed CCCA in the adolescent population, with three articles providing details of the presentation in the form of case series and retrospective reviews. The presentation in the adolescent population was found to be varied, ranging from asymptomatic to symptomatic and involving diffuse to patchy hair loss in only the vertex and/or frontal and parietal scalp. Genetic and environmental etiologies were found to be statistically significant, and markers of metabolic dysregulation predisposing patients to diabetes mellitus and breast cancer were also uncovered. The differential diagnosis of patients who present with hair loss in the adolescent population should therefore be broad, and a low threshold for biopsies should be adopted to confirm CCCA in suspected patients. This will have future implications for reduced morbidity and public health.

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“…Type 2 diabetes mellitus 3/5 1. Significantly higher odds of T2DM in patients with CCCA (OR = 4.13; 95% CI [2.76-6.18]; P < .05) 14 2. Significantly higher CCCA severity score in patients with T2DM compared to controls (P = .043) 15 3.…”

Section: Comorbidity Number Of Studies Showing Positive Association R...mentioning

confidence: 99%

Risk factors and comorbidities associated with central centrifugal cicatricial alopecia

Green,

Feschuk,

Valdebran

2023

International Journal of Women’s Dermatology

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Central centrifugal cicatricial alopecia (CCCA) is the most common form of scarring alopecia that most often affects Black women. The disease typically begins with hair loss in the center scalp, which progresses in a centripetal fashion. Both environmental insult and genetics have been implicated in CCCA etiology, although the exact pathophysiology remains unknown. Nevertheless, it is important that providers feel comfortable educating their patients on risk factors (RFs) for the development or worsening of CCCA, and potential comorbidities associated with the condition. Thus, the goal of this review was to summarize these factors. A comprehensive literature search was performed, and studies were included if they reported research on RFs for or comorbidities associated with, CCCA. A total of 15 studies were included: n = 5 researching RFs for CCCA and n = 10 researching comorbidities associated with CCCA. There was an association suggesting an increased risk of CCCA with traction hairstyles in n = 2/3 studies, previous pregnancies in n = 1/1 studies, and use of chemical hair relaxers in n = 1/3 studies. Additionally, age and total years of hair loss were associated with increased CCCA severity in n = 2/2 studies. Type 2 diabetes was positively associated with CCCA in n = 3/5 studies, uterine leiomyomas in n = 1/2 studies, hyperlipidemia in n = 1/2 studies, and vitamin D deficiency in n = 1/1 studies. Conflicting results regarding RFs and comorbidities associated with CCCA exist within the literature. Thus, further investigation in larger cohorts must be done, and future research into genes implicated in CCCA and their potential role in the development of other diseases is recommended.

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Association of type 2 diabetes with central centrifugal cicatricial alopecia: A follow-up study

Cited by 10 publications

References 6 publications

Cardiovascular risk in patients with scarring and nonscarring alopecias: Assessing the current state of evidence

Cardiovascular risk in patients with scarring and nonscarring alopecias: Assessing the current state of evidence

Central Centrifugal Cicatricial Alopecia in the Adolescent Population: An Overview of Available Literature

Risk factors and comorbidities associated with central centrifugal cicatricial alopecia

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