Lee Juwon, de Gregorio Ludovica, Tosti Antonella
Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Plastic Surgery, University Frederico II of Naples, Naples, Italy.
Skin Appendage Disord. 2025 Mar 20:1-8. doi: 10.1159/000545345.
Primary scarring alopecia is characterized by irreversible hair follicle destruction and chronic inflammation, which may create a microenvironment conducive to skin cancer development. Non-melanoma skin cancers (NMSCs), such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), are influenced by factors like UV exposure and prolonged inflammation. The link between primary scarring alopecia and increased scalp skin cancer risk remains unclear.
This review analyzed thirteen studies reporting NMSC in primary scarring alopecia subtypes, including lichen planopilaris, discoid lupus erythematosus, folliculitis decalvans, and erosive pustular dermatosis of the scalp. Chronic inflammation, UV exposure, and immunosuppressive therapies were identified as potential contributors to malignancy.
Primary scarring alopecia may increase susceptibility to SCC and BCC, particularly in areas of prolonged inflammation or immunosuppression. Clinicians should emphasize sun protection, routine follow-up, and patient education to minimize risk and improve outcomes. Further research is needed to clarify these associations.
原发性瘢痕性脱发的特征是毛囊不可逆性破坏和慢性炎症，这可能会营造一个有利于皮肤癌发生的微环境。非黑色素瘤皮肤癌（NMSCs），如鳞状细胞癌（SCC）和基底细胞癌（BCC），会受到紫外线暴露和长期炎症等因素的影响。原发性瘢痕性脱发与头皮皮肤癌风险增加之间的联系仍不明确。
本综述分析了13项报告原发性瘢痕性脱发亚型（包括扁平苔藓性毛囊病、盘状红斑狼疮、脱发性毛囊炎和头皮糜烂性脓疱病）中NMSC的研究。慢性炎症、紫外线暴露和免疫抑制疗法被确定为恶性肿瘤的潜在促成因素。
原发性瘢痕性脱发可能会增加患SCC和BCC的易感性，尤其是在长期炎症或免疫抑制区域。临床医生应强调防晒、定期随访和患者教育，以将风险降至最低并改善治疗效果。需要进一步研究来阐明这些关联。
