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

Abstract

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.

Risk factors and comorbidities associated with central centrifugal cicatricial alopecia

“…Limited work has been done to summarize these education points for clinicians beyond the CCCA associations shown with type 2 diabetes and uterine leiomyomas. 8 Thus, the goal of this review was to summarize the RFs and comorbidities associated with CCCA to provide further education to providers, further inform etiopathogenesis, and propose further treatment algorithms.…”