Skin of Color pp 105-122 | Cite as

Cicatricial Alopecias



This chapter provides a practical approach to the diagnosis and management of the most common types of primary cicatricial alopecias. In primary scarring alopecias, the target of the inflammation is the hair follicle. In secondary scarring alopecias, the hair follicle is an innocent bystander in the disease process and is destroyed in a nonspecific manner. Examples of secondary scarring alopecias include deep burns, radiation dermatitis, cutaneous malignancies, cutaneous sarcoidosis, morphea, necrobiosis lipoidica, and certain chronic infections such as cutaneous tuberculosis. Secondary forms of scarring hair loss are quite common and must be considered in the differential diagnosis of late-stage primary scarring hair loss when inflammatory clues are no longer available to help with diagnosis. The diagnostic hallmark of all forms of cicatricial alopecia (primary and secondary) is visible loss of follicular ostia. In this chapter, we will focus on helpful clinical clues that help distinguish the various primary scarring alopecias and allow distinction from potentially similar non-scarring alopecias. Treatments will be discussed based on the inflammatory level of typical pathologic examination of each entity.


Hair Follicle Mycophenolate Mofetil Hair Loss Lichen Planus Bullous Pemphigoid 


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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of DermatologyBoston University School of MedicineBostonUSA
  2. 2.Department of Dermatology, Medical Center BoulevardWake Forest University School of MedicineWinston-SalemUSA

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