Callender Valerie D, Wright Dakara Rucker, Davis Erica C, Sperling Leonard C
Callender Dermatology and Cosmetic Center, Glenn Dale, Maryland 20769, USA.
Arch Dermatol. 2012 Sep;148(9):1047-52. doi: 10.1001/archdermatol.2011.3428.
Central centrifugal cicatricial alopecia is the most common form of cicatricial alopecia in African American women. Treatment options are limited and mostly aimed at halting further hair loss but rarely result in hair regrowth. Therefore, it is important to recognize early clinical signs, perform a confirmatory biopsy, and begin treatment promptly. We have observed that hair breakage may be a key sign of early central centrifugal cicatricial alopecia, and this association is not clearly described in the literature.
Nine patients with hair breakage on the vertex with or without scalp symptoms underwent scalp biopsies as part of their evaluation. Of these, 8 had histologic samples adequate for complete interpretation: 5 specimens (63%) showed histologic changes typical of central centrifugal cicatricial alopecia, with 1 of these showing advanced end-stage changes of cicatricial alopecia. Two (25%) revealed premature desquamation of the inner root sheath as the sole finding suggestive of early central centrifugal cicatricial alopecia and 1 (13%) was normal.
Although hair breakage can have multiple causes, early central centrifugal cicatricial alopecia must be considered in the differential diagnosis, particularly in women of African ancestry. Histologic evaluation may reveal early or late findings that can help establish the diagnosis.
中心性离心性瘢痕性秃发是非洲裔美国女性中最常见的瘢痕性秃发形式。治疗选择有限，主要旨在阻止进一步脱发，但很少能使头发再生。因此，识别早期临床体征、进行确诊性活检并及时开始治疗很重要。我们观察到，毛发断裂可能是早期中心性离心性瘢痕性秃发的关键体征，而这种关联在文献中并未得到明确描述。
9例头顶有毛发断裂且伴有或不伴有头皮症状的患者接受了头皮活检，作为其评估的一部分。其中，8例有足够的组织学样本用于完整解读：5份标本（63%）显示出中心性离心性瘢痕性秃发的典型组织学变化，其中1份显示出瘢痕性秃发的晚期终末期变化。2份（25%）仅显示内根鞘过早脱屑，提示早期中心性离心性瘢痕性秃发，1份（13%）正常。
尽管毛发断裂可能有多种原因，但在鉴别诊断中必须考虑早期中心性离心性瘢痕性秃发，尤其是在非洲裔女性中。组织学评估可能揭示有助于确诊的早期或晚期表现。
