Qi Shiling, Zhao Ying, Zhang Xiaoting, Li Shuifeng, Cao Hui, Zhang Xingqi
Department of Dermatology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
Indian J Dermatol Venereol Leprol. 2014 Jul-Aug;80(4):306-12. doi: 10.4103/0378-6323.136833.
There have been few reports on primary cicatricial alopecias (PCR) especially from Asia (PCA).
To study the clinical, pathological and dermoscopic characteristics of PCA among Chinese patients.
A retrospective analysis of the clinical data of 59 patients with PCA was conducted and the dermoscopic, pathological, treatment and prognosis characteristics analyzed. Fisher's Chi-square exact test, Kruskal-Wallis and Spearman rank correlation test were performed.
The ratio of neutrophilic to lymphocytic cicatricial alopecias was about 1.3:1 in this group. The most frequent disorder was folliculitis decalvans. Follicular openings were absent on dermoscopy in all cases except alopecia mucinosa. Patulous follicular openings were characterisitc of alopecia mucinosa. After treatment, an increase in short vellus hairs was the earliest feature, while telangiectasia, epidermal scale, follicular hyperkeratosis, pustules and hair diameter diversity gradually decreased or even disappeared. Improvement in the areas of hair loss after treatment was seen more often in discoid lupus erythematosus, folliculitis decalvans and dissecting cellulitis than in patients with classic pseudopelade of Brocq. Nine patients (13.6%) relapsed after cessation of therapy. Female patients needed longer treatment times. Long duration, large areas of hair loss and shorter treatment courses were the major factors in relapses.
Dermatoscopy provides a rapid, practical and useful aid for the diagnosis of PCA and also to assess disease activity. Patulous follicular openings are a specific dermoscopic sign of alopecia mucinosa. Lichen planopilaris is less common in China than in the West.
关于原发性瘢痕性脱发（PCR）的报道较少，尤其是来自亚洲（PCA）的报道。
研究中国患者中PCA的临床、病理和皮肤镜特征。
对59例PCA患者的临床资料进行回顾性分析，并分析其皮肤镜、病理、治疗及预后特征。进行了Fisher卡方精确检验、Kruskal-Wallis检验和Spearman秩相关检验。
该组中性粒细胞性与淋巴细胞性瘢痕性脱发的比例约为1.3:1。最常见的疾病是脱发性毛囊炎。除黏液性脱发外，所有病例在皮肤镜检查中均无毛囊开口。扩张的毛囊开口是黏液性脱发的特征。治疗后，最早出现的特征是短毳毛增多，而毛细血管扩张、表皮鳞屑、毛囊角化过度、脓疱和毛发直径差异逐渐减少甚至消失。治疗后脱发区域的改善在盘状红斑狼疮、脱发性毛囊炎和蜂窝织炎患者中比在经典的布罗克假性斑秃患者中更常见。9例患者（13.6%）在治疗停止后复发。女性患者需要更长的治疗时间。病程长、脱发面积大及治疗疗程短是复发的主要因素。
皮肤镜检查为PCA的诊断及疾病活动度评估提供了一种快速、实用且有用的辅助手段。扩张的毛囊开口是黏液性脱发的特异性皮肤镜表现。扁平苔藓性毛囊炎在中国比在西方少见。
