Clinicopathologic and immunophenotypic characterization of lichen planopilaris and central centrifugal cicatricial alopecia: A comparative study of 51 cases

Abstract

BackgroundThe purpose of the study was to compare the histopathologic and immunophenotypic features of central centrifugal cicatricial alopecia (CCCA) and lichen planopilaris (LPP) to better characterize and differentiate these two clinical entities. CCCA remains an ill‐defined and still‐unsettled histologic entity and many hair loss experts regard CCCA to be histologically indistinguishable from LPP. Given the overlapping histologic features of these two lymphocyte‐predominant cicatricial alopecias, and the lack of consensus regarding the significance of proposed distinctions, dermatopathologists face difficulty in providing clinicians and patients certainty with a definitive diagnosis of CCCA vs LPP.MethodsWe performed a retrospective review of 51 scalp biopsies of patients with either the clinical diagnosis of CCCA (27 cases) or LPP (24 cases). Clinical information, histologic features of hematoxylin‐eosin‐stained sections, and a panel of immunohistochemical markers were evaluated on scalp biopsies. Tested parameters were quantified, and statistical analysis was performed.ResultsOur study found no differences on either histologic assessment or immunophenotypic characterization between cases of classic LPP and CCCA.ConclusionThe conclusion of this study is that the inflammatory infiltrates in CCCA and LPP are not only histologically similar but also immunophenotypically indistinguishable.

Hypertension and Cicatricial Hair Loss: Defining High Value Symptom Clusters within Reproductive Aging

“…Two forms of cicatricial hair loss are increasing in frequency, central centrifugal cicatricial alopecia (CCCA) and frontal fibrosing alopecia (FFA). CCCA and FFA have epidemiologic features such as gender, racial predominance, scalp site specificity and an association with the reproductive axis that are suitable for longitudinal database modeling [1][2][3]. In this study, both African American and Caucasian women with cicatricial hair loss had a higher risk of hypertension.…”

Deimination and Peptidylarginine Deiminases in Skin Physiology and Diseases

“…Hair-breakage and thinning at the vertex scalp progress centrifugally. Histopathological examinations of skin biopsies reveal perifollicular lymphocyte infiltration and fibrosis [69], and follicular degeneration (Figure 5f,g). The disease is associated with traction-inducing hair-grooming practices and usage of hair-irritant chemicals.…”

Lichen planus follicularis tumidus: Immunotyping of the inflammatory infiltrate with focus on plasmacytoid dendritic cells

“…Clinically, the most common localization of LPFT is the retroauricular region, but the ears, the eyelids, the cheeks, the chin, the nose, and the scalp may be also involved 1 . Histopathologically, LPFT shows features typical of LP (a lichenoid, band‐like infiltrate with orthohyperkeratosis, hypergranulosis, and vacuolar degeneration of the basal layer) and lichen planopilaris (LPP; preferential involvement of the hair follicles with sparing of the interfollicular epidermis) 1,2,7,14,15 ; in LPFT, an exaggerated hyperkeratotic reaction selectively occurs at the level of the infundibula, resulting in comedo‐like structures and cysts filled with keratin. The presence of copious eosinophils within the inflammatory infiltrate was reported in an exceptional case of anti‐PD‐1 therapy‐associated LPFT‐like cutaneous drug reaction 5 .…”