A clinical and histopathological study of cicatricial alopecia

Abstract

Objective To document the causes and clinical and histopathological features of cicatricial alopecia. Patients and methods A study of 40 patients was conducted to study the clinical variants and histopathology of cicatricial alopecia. Results In our study, major causes of cicatricial alopecia were lichen planopilaris (27.5%), discoid lupus erythematosus (25%), pseudopelade of Brocq (20%), systemic lupus erythematosus (5%) followed by scleroderma, dermatomyositis, keratosis follicularis spinulosa decalvans, aplasia cutis, kerion, follicular mucinosis, pemphigus, dissecting cellulitis of scalp/ pyogenic folliculitis and acne keloidalis nuchae in 2.5% cases each. Morphological features included epidermal atrophy in 90%, erythema in 55%, follicular plugging in 40%, telangiectasia in 27.5%, diffuse scaling in 25% and mottled hyperpigmentation in 20% patients. The commonest histopathological features were perifollicular fibrosis in 65%, basal cell vacuolization in 52.5%, perifollicular lymphocytic infiltrate in 50%, epidermal atrophy in 35% and hyperkeratosis in 20% patients. Conclusion Lichen planopilaris, discoid lupus erythematosus, pseudopelade of Brock were the common causes of cicatricial alopecia in the studied population.