Central centrifugal cicatricial alopecia: retrospective chart review.

Overview

BACKGROUND: Few studies have investigated central centrifugal cicatricial alopecia (CCCA). Thus, our understanding of CCCA is largely based on anecdotal evidence. OBJECTIVE: The purpose of this study was to investigate clinical characteristics and hair care practices in CCCA patients. METHODS: We conducted a single-center retrospective chart review of patients with a clinicopathologic diagnosis of CCCA. RESULTS: Medical records of 69 patients were reviewed. Of these, 97% were female. The mean ages at onset and presentation were 38.2 and 42.4 years, respectively. All subjects for whom hair care data were available had used a traumatic practice at least once, the most common being chemical relaxer. Family history data were available for 27 subjects (39%). Of these, 56% had a positive family history of hair loss. Seborrheic dermatitis was the leading concurrent diagnosis. LIMITATIONS: Limitations include lack of a control group, retrospective design, and selection bias. CONCLUSIONS: Our results confirm that CCCA primarily affects adult women of African descent. The majority of patients presented several years after onset, suggesting that efforts to encourage earlier diagnosis are warranted. Although the role of hair care remains unclear, traumatic practices were reported in all patients in our study for whom hair care was documented.