88 - Cicatricial Alopecias

Question 1

Refers to a group of idiopathic inflammatory disorders, characterized by a folliculocentric inflammatory process that ultimately destroys the hair follicle

Answer 1

Primary cicatricial alopecias

Question 2

Can be caused by almost any cutaneous inflammatory process of the scalp skin or physical trauma, which injures the skin and skin appendages

Answer 2

Secondary cicatricial alopecias

Question 3

Primary cicatricial alopecias are characterized by inflammatory infiltrate affecting the upper, permanent portion of the follicle referred to as the _____, and the below it, the _____ of the follicule

Answer 3

Infundibulum

Isthmus

Question 4

The isthmus is the home of the pluripotent hair stem cells, which are found in the _____ region where the arrector pili muscle attaches to the outer root sheath

Answer 4

Bulge

Question 5

It has been assumed that scarring hair loss is a consequence of damage to the isthmus, affecting either

Answer 5

Stem cells

Sebaceous glands

Question 6

Lymphocytic primary cicatricial alopecias

Answer 6

Chronic cutaneous lupus erythematosus
Lichen planopilaris
Classic lichen planopilaris
Frontal fibrosing alopecia
Graham-Little syndrome
Central centrifugal cicatricial alopecia
Alopecia mucinosa
Keratosis follicularis spinulosa decalvans

Question 7

Neutrophilic primary cicatricial alopecias

Answer 7

Folliculitis decalvans

Dissecting cellulitis/folliculitis

Question 8

Mixed cicatricial alopecia

Answer 8

Folliculitis (acne) keloidalis
Folliculitis (acne) necrotica
Erosive pustular dermatosis

Question 9

No disease activity should occur on the scalp for at least _____ after which hair restoration surgery can begin

Answer 9

1 year

Question 10

The patient has to be warned about a possible limited graft survival and disease recurrence, which seems to be higher in _____ primary scarring alopecia

Answer 10

Neutrophilic

Question 11

_____, together with LPP, is the most common cause of inflammatory cicatricial alopecia

Answer 11

DLE

Question 12

LPP can be divided into

Answer 12

Classic LPP
Graham-Little syndrome
Frontal fibrosing alopecia

Question 13

Alopecic areas of _____ are often smaller, irregularly shaped and interconnected, which can lead to a reticulated clinical pattern as compared to DLE

Answer 13

LPP

Question 14

Frontal, band-like or circumferential scarring alopecia

Alopecia of the eyebrows is also frequently seen

Answer 14

Frontal fibrosing alopecia

Question 15

Classic LPP on the scalp, nonscarring alopecia of axillae, pubic area, and eyebrows, as well as keratosis pilaris of the trunk and extremities

Answer 15

Graham-Little syndrome

Question 16

Small flesh-toned alopecic patches with irregular margins

“Foot prints in the snow”

Answer 16

Pseudopelade of Brocq

Question 17

Treatment of choice for pseudopelade of Brocq

Answer 17

Intralesional triamcinolone in combination with topical corticosteroids

Question 18

Most common form of primary cicatricial alopecia in women of African American descent

Answer 18

Central centrifugal cicatricial alopecia

Question 19

CCCA seen in whites

Answer 19

Central elliptical pseudopelade

Question 20

Indurated, well-demarcated, erythematous or skin-colored patches of scarring or nonscarring alpecia that can be accompanied by diffuse hair loss and alopecia of the eyebrows
Can occur idiopathically or in the setting of CTCL or MF

Answer 20

Alopecia mucinosa

Question 21

Congenital follicular keratinizing disorders

Answer 21

Keratosis follicularis spinulosa decalvans
Ulerythema ophryogenes
Atrophoderma vermiculatum

Question 22

A bacterial infection involving Staphylococcus aureus, in combination with hypersensitivity reaction to “superantignes” and defect in host cell-mediated immunity have all been suspected as possible pathogenic factors

Answer 22

Folliculitis decalvans

Question 23

Multiple hairs emerging from a single, dilated, follicular orifice

Answer 23

Tufted folliculitis

Question 24

Follicular occlusion triad

Answer 24

Dissecting folliculitis
Acne conglobata
Hidradenitis suppurativa

Question 25

Fluctuating nodules, abscesses, and sinuses, which frequently show spontaneous discharge of pus, as well as erythematous, follicular papules and pustules

Answer 25

Dissecting folliculitis

Question 26

Idiopathic primary cicatricial alopecia that might be triggered by trauma (shirt collars) or infection (Demodex or bacteria)

Answer 26

Acne keloidalis nucahe

Question 27

Treatment of first choice for acne keloidalis nucahe

Answer 27

Intralesional triamcinoloe acetonide
alone or combined with
Topical clindamycin or oral (tetracylines) antibiotics

Question 28

Umbilicated, pruritic, or painful papules that undergo central necrosis
Frontal and parietal scalp, as well as seborrheic areas of the face are most commonly affected

Answer 28

Acne necrotica (varioliformis)

Question 29

Predominantly occurring in elderly women

Suppurative, necrotic, erosive papule or plaque

Answer 29

Erosive pustular dermatosis

Question 30

Possible causes of secondary cicatricial alopecia

Answer 30

Congenital defects
Trauma
Inflammatory conditions
Infections
Neoplasms
Rarely, drugs

Question 31

Ectothrix infection is most commonly caused by

Answer 31

Microsporum spp

Epidermophyton spp

Question 32

Endothrix infection is most commonly caused by

Answer 32

Trichophyton spp

Question 33

Traumatic alopecias are usually of 3 types

Answer 33

Acute trauma
Prolonged traction
Pressure

Question 34

Marginal traction alopecia is more commonly seen in

Answer 34

African American women from hair braiding and weaving procedures

Question 35

Patchy traction alopecia in the frontal hairline or temples is commonly seen in

Answer 35

Sikh boys, whose hair is usually tight up in a “topknot”

Question 36

Two forms of trichotillomania can be distinguised

Answer 36

Infantile or early-onset

Late-onset