Yongpisarn Tanat, Tejapira Kasama, Suchonwanit Poonkiat
Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Front Immunol. 2025 Aug 29;16:1516407. doi: 10.3389/fimmu.2025.1516407. eCollection 2025.
Primary cicatricial alopecia (PCA) is known to be associated with various comorbidities; however, findings regarding the likelihood of specific comorbidities in PCA patients have been inconsistent.
This study aimed to assess the prevalence and odds of specific comorbidities in patients with PCA compared to controls, and to explore the distribution of comorbidities across various types of PCA.
Electronic searches were conducted using PubMed, Embase, and Scopus from the dates of their inception until July 2024. A total of 116 studies with 33,494 PCA patients that reported data allowing for the calculation of odds ratios (OR) or prevalences of certain comorbidities in PCA patients were included.
Systemic lupus erythematosus is more prevalent among patients with lichen planopilaris (LPP) [OR 3.10 (95% confidence interval: 2.24-4.29), prevalence 2%], frontal fibrosing alopecia (FFA) [OR 6.92 (2.73-17.56), prevalence 5%], and central centrifugal cicatricial alopecia (CCCA) [OR 3.13 (1.03-9.49), prevalence 5%]. Hypothyroidism is more prevalent among patients with LPP [OR of 1.73 (1.24-2.42), prevalence 17%] and FFA [OR 1.86 (1.36-2.55), prevalence 19%]. LPP patients are prone to having dermatological diseases such as atopic dermatitis [OR 3.96 (1.14-13.81), prevalence 9%], lichen planus [OR 19.21 (1.47-251.02), prevalence 8%], psoriasis [OR 4.75 (2.04-11.06), prevalence 3%], and rosacea [OR 4.62 (2.96-7.19), prevalence 5%], while FFA patients are prone to having allergic contact dermatitis [OR 3.19 (1.44-7.08), prevalence 41%] and rosacea [OR 2.37 (1.72-3.29), prevalence 16%]. Coronary artery disease is found to be more common in LPP than controls [OR 1.63 (1.43-1.86), prevalence 8%], while dyslipidemia is more common among FFA [OR 1.41 (1.06-1.88), prevalence 20%] and CCCA [OR 4.46 (1.01-19.75), prevalence 54%] than controls, and diabetes mellitus is more prevalent among CCCA than controls [OR 1.67 (1.03-2.69), prevalence 26%]. While skin cancer [OR 2.22 (1.33-3.70), prevalence 2%] and melanoma [OR 4.46 (1.70-11.76), prevalence 1%] were found to be more common in LPP than controls, rheumatoid arthritis [OR 1.65 (1.09-2.51), prevalence 4%] was found to be more common in FFA than controls, and allergic rhinitis [OR 11.77 (1.55-89.24), prevalence 24%] and anxiety [OR 4.69 (1.29-16.98), prevalence 17%] were found to be more common in CCCA than controls.
Patients with PCA are at higher risk of developing a wide range of comorbidities. Physicians should remain vigilant and conduct thorough investigations when clinical clues are present.
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=564852, identifier CRD42024564852.
已知原发性瘢痕性脱发（PCA）与多种合并症相关；然而，关于PCA患者特定合并症发生可能性的研究结果并不一致。
本研究旨在评估PCA患者与对照组相比特定合并症的患病率和比值比，并探讨合并症在各种类型PCA中的分布情况。
使用PubMed、Embase和Scopus进行电子检索，检索时间从各数据库建库至2024年7月。共纳入116项研究，涉及33494例PCA患者，这些研究报告了可用于计算PCA患者某些合并症比值比（OR）或患病率的数据。
系统性红斑狼疮在扁平苔藓性毛发扁平苔藓（LPP）患者中更为常见[OR 3.10（95%置信区间：2.24 - 4.29），患病率2%]、额部纤维性脱发（FFA）患者中[OR 6.92（2.73 - 17.56），患病率5%]以及中央离心性瘢痕性脱发（CCCA）患者中[OR 3.13（1.03 - 9.49），患病率5%]。甲状腺功能减退在LPP患者中更为常见[OR 1.73（1.24 - 2.42），患病率17%]和FFA患者中[OR 1.86（1.36 - 2.55），患病率19%]。LPP患者容易患皮肤病，如特应性皮炎[OR 3.96（1.14 - 13.81），患病率9%]、扁平苔藓[OR 19.21（1.47 - 251.02），患病率8%]、银屑病[OR 4.75（2.04 - 11.06），患病率3%]和玫瑰痤疮[OR 4.62（2.96 - 7.19），患病率5%]，而FFA患者容易患过敏性接触性皮炎[OR 3.19（1.44 - 7.08），患病率41%]和玫瑰痤疮[OR 2.37（1.72 - 3.29），患病率16%]。发现冠状动脉疾病在LPP患者中比对照组更常见[OR 1.63（1.43 - 1.86），患病率8%]；而血脂异常在FFA患者中[OR 1.41（1.06 - 1.88），患病率20%]和CCCA患者中[OR 4.46（1.01 - 19.75），患病率54%]比对照组更常见；糖尿病在CCCA患者中比对照组更普遍[OR 1.67（1.03 - 2.69），患病率26%]。虽然皮肤癌[OR 2.22（1.33 - 3.70），患病率2%]和黑色素瘤[OR 4.46（1.70 - 11.76），患病率1%]在LPP患者中比对照组更常见，但类风湿关节炎[OR 1.65（1.09 - 2.51），患病率4%]在FFA患者中比对照组更常见，过敏性鼻炎[OR 11.77（1.55 - 89.24），患病率24%]和焦虑症[OR 4.69（1.29 - 16.98），患病率17%]在CCCA患者中比对照组更常见。
PCA患者发生多种合并症的风险更高。医生在出现临床线索时应保持警惕并进行全面检查。
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=564852，标识符CRD42024564852 。
