Madura C, Vinay N, Kusuma M R, Harsha S, Chandrashekar B S
Department of Dermatosurgery, CUTIS Academy of Cutaneous Sciences, MRCR Layout, Bengaluru, Karnataka, India.
Int J Trichology. 2020 Jul-Aug;12(4):164-167. doi: 10.4103/ijt.ijt_52_19. Epub 2020 Sep 19.
Cicatricial alopecia (CA) is scarring alopecia due to a diverse group of disorders which destroy the hair follicle, replace it with scar tissue causing permanent hair loss. Spontaneous regrowth of hair in CA is rarely seen and thus it has a negative impact on the self-esteem of the patient. However, hair transplantation (HT) has emerged as an effective modality of treatment to replace lost hair for cosmetic benefit.
This was a prospective analysis of patients affected with CA, who underwent HT from January 2015 to December 2017. Demography of patients along with the duration of disease, stability, biopsy, technique of HT, number of grafts, and other procedures done were noted on a pro forma and analyzed. A test patch of HT was done in all primary CA to assess stability and few secondary CA to look for graft uptake. The patients were followed up for a year and the outcomes were graded by patient and a single observer on a 10 point scale as poor, satisfactory, good, and very good at 3, 6, and 12 months.
A total of 50 patients with CA underwent follicular unit extraction. Majority of them were males(84%) with a male to female ratio of 5.25:1. Secondary CA was seen in majority(90%) of the study group. Moustache (56%) was the most common site affected, followed by scalp (22%), beard(14%) and eyebrow(8%). Around 38%(12 atrophic scars; 7 hypertrophic scars) underwent fractional CO2 laser/Erbium YAG laser with or without intralesional steroid injections in a stepwise manner prior to HT. Excellent-to-very good outcome was seen in 82% while 18% were lost for follow up.
Scarring in CA has a significant effect on quality of life of affected patients. HT when done taking into consideration the stability of disease has good-to-excellent outcomes thus leading to a positive impact on the patient's life.
瘢痕性脱发（CA）是一种瘢痕性脱发，由多种破坏毛囊的疾病引起，毛囊被瘢痕组织替代，导致永久性脱发。CA中毛发很少能自发再生，因此对患者的自尊心有负面影响。然而，毛发移植（HT）已成为一种有效的治疗方式，可用于替代脱发以达到美容效果。
这是一项对2015年1月至2017年12月期间接受HT的CA患者的前瞻性分析。在一份表格上记录患者的人口统计学信息以及疾病持续时间、稳定性、活检、HT技术、移植单位数量和其他所做的手术，并进行分析。对所有原发性CA患者进行HT测试贴片以评估稳定性，对少数继发性CA患者进行测试贴片以观察移植片的摄取情况。对患者进行了一年的随访，患者和一名观察者在3个月、6个月和12个月时按照10分制将结果分为差、满意、良好和非常好四个等级。
共有50例CA患者接受了毛囊单位提取。其中大多数为男性（84%），男女比例为5.25:1。研究组中大多数（90%）为继发性CA。受影响最常见的部位是胡须（56%），其次是头皮（22%）、络腮胡（14%）和眉毛（8%）。约38%（12例萎缩性瘢痕；7例增生性瘢痕）在HT前逐步接受了分次二氧化碳激光/铒钇铝石榴石激光治疗，伴或不伴病灶内类固醇注射。82%的患者获得了优秀至非常好的结果，18%的患者失访。
CA中的瘢痕对受影响患者的生活质量有显著影响。考虑到疾病稳定性进行HT时，可获得良好至优秀的结果，从而对患者生活产生积极影响。
