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Follicular
degeneration syndrome
"Follicular degeneration syndrome" goes under a variety of names
including "central progressive alopecia" and "hot comb
alopecia".
Follicular degeneration syndrome was first identified in black
African-American women and thought to be due to the overuse of hot
combs and oil pomades. It was though that the oils applied to the
hair were heated up by the hot comb and liquified. The liquid oil
then dribbled down the hair fiber into the hair follicle opening
and irritated the skin causing inflammation around the upper hair
follicle. However, it is now known that, while hot combing might
elicit the condition in some individuals, it can also occur in the
absence of any cosmetic procedure. With this discovery the condition
has been renamed follicular degeneration syndrome.
It is a form of scarring alopecia which is most often first visible
as a well defined patch of diffuse hair loss. The affected region
usually, although not always, extends centrifugally from the scalp
vertex. The affected region may slowly expand in size with time.
Skin biopsies show that the condition involves inflammation of the
affected hair follicles and premature desquamation of the hair follicle
inner root sheath.
Usually treatment focuses on removing the hair follicle inflammation
using topical corticosteroids in intradermal corticosteroid injection.
No reliable or proven treatment is known.
Follicular
degeneration syndrome references
- Sperling
LC, Skelton HG 3rd, Smith KJ, Sau P, Friedman K. Follicular degeneration
syndrome in men. Arch Dermatol. 1994 Jun;130(6):763-9.
- Sperling
LC, Sau P. The follicular degeneration syndrome in black patients.
'Hot comb alopecia' revisited and revised. Arch Dermatol. 1992
Jan;128(1):68-74.
- Sperling LC. Scarring alopecia and the
dermatopathologist. J Cutan Pathol. 2001 Aug;28(7):333-42.
- Sullivan JR, Kossard S. Acquired scalp
alopecia. Part II: A review. Australas J Dermatol. 1999 May;40(2):61-70
- Scott DA. Disorders of the hair and scalp
in blacks. Dermatol Clin. 1988 Jul;6(3):387-95.
- LoPresti P, Papa CM, Kligman AM. Hot comb
alopecia. Arch Dermatol. 1968 Sep;98(3):234-8.
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