A clinical and histopathological study of cicatricial alopecia

Abstract

Introduction: Cicatrical alopecia occurs in otherwise healthy men and women of all ages and is seen worldwide Material and Methods: A study of 40 patients was conducted to study the clinical variants and histopathology of cicatricial alopecia. Results and Discussion: n our study, it was seen that maximum number of cases of cicatrical alopecia were of LPP (27.5%) followed by 25% of DLE, 20% patients had pseudopelade of Brocq, SLE was seen in 5% cases followed by Scleroderma, dermatomyositis, Keratosis follicularis spinulosa decalvans, aplasia cutis, kerion, follicular mucinosis, pemphigus, dissecting cellulitis of scalp/ pyogenic folliculitis and acne keloidalis nuchae in 2.5% cases each. Regarding the morphology of lesions,epidermal atrophy was seen in 90% patients, erythema was seen in 55% cases, follicular pluging was seen in 40% patients, telangiectasias in 27.5% patients, diffuse scaling in 25% patients and mottled hyperpigmentation was seen in 20% patients. In our study, commonest histopathological feature of alopecia was perifollicular fibrosis seen in 65% patients, basal cell vacuolization was seen in 52.5% patients,perifollicular lymphocytic infiltrate were seen in 50% patients, epidermal atrophy seen in 35% patients and hyperkeratosis was seen in 20% patients.

Recurrent presumed herpes simplex keratitis and episcleritis in keratosis follicularis (Darier's disease)

“…Darier's disease is caused by mutations in the ATP2A2 gene (12q23-24.1), which encodes the sarcoplasmic/endoplasmic reticulum ATP-dependent calcium pump (SERCA2) 1. Loss of function in this gene leads to impaired desmosome function, especially in ectodermal tissues.…”

“…Keratosis follicularis (Darier's disease), is an autosomal dominant disorder of the epidermis characterised by abnormal epidermal differentiation and loss of normal cell-to-cell adhesion 1. Cardinal features on clinical examination of the skin include diffuse hyperkeratotic and warty papules with scaly plaques in the seborrhoeic regions along with mucous membrane changes.…”

Keratosis follicularis spinulosa decalvans associated with acne keloidalis nuchae

“…Acne keloidalis nuchae is a chronic disorder associated with folliculitis that is often seen in the neck area of young adult males. Grouped papules and pustules occur in the first stages of the disease, and in the later stages, keloidal papules, nuchal hypertrophic scars, chronic abscesses, and hair loss can be seen [12,13]. The exact cause of AKN is not yet known, but frequently suggested etiological possibilities are short haircuts along the posterior hairline and penetration of the cut hair into the skin, as in patients with pseudofolliculitis.…”

Chronic Thumb Pain of 11 Years Duration: What It Could Be?

“…5,6,7 However changes of erythronychia along with distil notching of the nail plate like that of Darier's disease can be present in subungual glomus tumor as seen in our patient. 8,9 The treatment for glomus tumors is total excision. Complete excision is curative and necessary to avoid recurrence.…”