Scarring alopecia: Clinical and pathologic study of 54 African-American women

Abstract

Background: Cicatricial or scarring alopecia results in the destruction of hair follicles and is a significant cosmetic concern in African-American women. Objective: To correlate the clinical examination and histologic findings in African-American women with scarring alopecia with a history of hairstyling practices. Methods: We reviewed retrospectively the medical records and scalp biopsy specimens of 54 women with scarring alopecia. Patients were selected from two dermatologic practices in the Detroit Metropolitan area. Results: Alopecia commonly presents in patients who use a variety of traumatic haircare techniques, including chemical and physical straighteners, traction, braiding, hair extensions, hair gluing, and chemical curls. Histologic findings are centered around the follicular infundibulum with a lymphocytic infiltrate and perifollicular fibrosis. Conclusion: Traumatic hairstyling techniques are common in African-American women, and all result in a similar picture of a peri-infundibular lymphocytic infiltrate and fibrosis, leading to alopecia. © 2009 International Society of Dermatology.