• Secondary cicatricial alopecias overview

Secondary cicatricial alopecias overview

The word alopecia means ‘loss of hair’, especially scalp hair. Scarring or cicatricial alopecias are a diverse group of hair loss disorders that affect the scalp skin (and at times attack hair bearing skin on other parts of the body). Scarring alopecias are generally divided into two broad categories – Primary Cicatricial Alopecias and Secondary Cicatricial Alopecias. In Primary Cicatricial Alopecias the inflammation of the hair follicle is a direct process whereas in the case of Secondary Cicatricial Alopecias the hair follicle is affected as a result of a comprehensive disease process that damages other tissues and organs, affecting and destroying the hair follicle as a side effect of this larger disease process.

This review of secondary scarring alopecias is dedicated to analyzing the different secondary alopecia conditions – causes, clinical features, histology (the branch of biology concerned with the microscopic study of the structure of tissues) and treatment, et al – in the light of available information derived from various research studies on the subject. The reviews have been arranged in line with the tried and tested system of enumerating the conditions as per their causal factors. Causal factors of secondary cicatricial alopecias are many and varied.

Causes of secondary scarring alopecia (secondary cicatricial alopecia):

• 1. Infections
  • Bacterial
  • Fungal
  • Viral

• 2. Dermatoses
  • Psoriasis
  • Pityriasis Amiantacea

• 3. Pattern Hair Loss / Senescent Alopecia

• 4. Bullous Disorders
  • Cicatricial pemphigoid
  • Epidermolysis bullosa

• 5. Physical and Chemical Causes
  • Ischemia / pressure
  • Thermal injury
  • Corrosive injury / toxic injury
  • Traction alopecia / trichotillomania

• 6. Radiation

• 7. Drugs

• 8. Autoimmune Disorders
  • Graft vs. host disease
  • Scleroderma (En coup de sabre)
  • Lichen sclerosis et atrophicus

• 9. Neoplasia
  • Malignant
        Primary
        Metastatic
        Atypical Lymphoproliferative Disorders
  • Hamartoma
        Syringiomas
        Generalized Follicular Hamartoma
        Organoid nevus

• 10. Granulomatous
  • Sarcoid
  • Necrobiosis lipoidica

• 11. Developmental / Hereditary
  • Fibrodysplasia
  • Darier's disease
  • Ectodermal dysplasias
  • Ichthyosis
        Congenital ichthyosiform erythroderma
        Lamellar ichthyosis
        KID syndrome
        Conradi-Hiinermann chondrodysplasia punctata
  • Incontinentia pigmenti
  • Asplasia cutis congenita

• 12. Miscellaneous
  • POEMS syndrome
  • Lipedematous alopecia
  • Porokeratosis

Scarring or cicatricial alopecias – primary and secondary – represent a heterogeneous group of hair loss disorders with varied etiologies (etiology is a branch of knowledge concerned with the causes of particular phenomena, specifically a branch of medical science concerned with the causes and origins of diseases). Continued research in this field is probing into follicle cycle and genetic abnormalities of hair production (in both humans and animals). Research findings are sure to aid the unveiling or uncovering of the specific etiologic factors and allow the proper development of targeted therapies. The available therapies are undoubtedly good but not sufficient to bring the progression of cicatricial alopecia to a standstill. A lot has to be done in this sphere, but a huge challenge awaits the researchers and dermatologists.