Cicatricial Alopecias Flashcards
What does trichoscopy reveal in Classic Lichen Planopilaris?
Perifollicular staining and areas with no hair follicle openings
Perifollicular staining indicates inflammation around hair follicles.
What is the histological finding in Classic Lichen Planopilaris?
Lymphocytic infiltrate involving the isthmus and infundibulum
The isthmus and infundibulum are parts of the hair follicle.
Which areas are most commonly affected by Frontal Fibrosing Alopecia?
Frontotemporal hairline
The condition typically involves a selective loss of hair at the frontal and temporal regions.
What additional findings may occur with Frontal Fibrosing Alopecia?
- Loss of eyebrows
- Facial papules
These findings are commonly associated with the condition.
What does trichoscopy reveal in cases of Frontal Fibrosing Alopecia?
- Perifollicular scaling
- ‘Lonely hairs’
What is the common site for Central Centrifugal Cicatricial Alopecia?
A slowly progressive, symmetric cicatricial alopecia centered on the mid scalp and vertex
Who is most often affected by Central Centrifugal Cicatricial Alopecia? What is associated mutation?
Most often develops in Black women
This condition may also be associated with mutations in PADI3
What are some treatments for Central Centrifugal Cicatricial Alopecia?
Treatment includes:
* Topical corticosteroids
* Intralesional corticosteroids
* Oral tetracyclines
* Adjuvant immunosuppressive drugs
These treatments aim to manage symptoms and slow progression.
What are the key features of early lesions in Discoid Lupus Erythematosus?
Erythema, scaling, and dilated, plugged follicular ostia
What are the first-line therapies for Discoid Lupus Erythematosus?
Antimalarial drugs and intralesional corticosteroids
What type is inheritance pattern of Keratosis Follicularis Spinulosa Decalvans? What spectrum does the condition sit within?
Rare X-linked recessive disorder
It is within the spectrum of keratosis pilaris atrophicans.
What are the key features of Keratosis Follicularis Spinulosa Decalvans?
• Rare X-linked recessive disorder
• Keratosis pilaris-like papules favoring the scalp and face
• Follicular atrophy and scarring alopecia can follow resolution of papules
These features help in identifying and diagnosing the condition.
Where do Keratosis pilaris-like papules typically appear in Keratosis Follicularis Spinulosa Decalvans?
Favor the scalp and face
What can occur after the resolution of papules in Keratosis Follicularis Spinulosa Decalvans?
Follicular atrophy and scarring alopecia
What type of alopecia is Folliculitis Decalvans classified as?
Neutrophilic cicatricial alopecia
This condition may indicate an altered immune response to the follicular microbiome.
What are the most characteristic findings when Folliculitis Decalvans is active?
Follicular pustules and hair tufts
These findings are key indicators of the condition during its active phase.
What is the most common treatment for Folliculitis Decalvans?
Doxy
Mino
Rifampicin/clinda
Isotretinoin
What is another name for Acne Keloidalis?
Acne keloidalis nuchae, Folliculitis keloidalis
What are the key features of Acne Keloidalis?
Persistent folliculitis on the nape of the neck with formation of keloid-like scars and cicatricial alopecia
In which demographic is Acne Keloidalis most common?
Black men
What are treatment options for Acne Keloidalis?
Intralesional triamcinolone
Doxycycline
Low dose isotretinoin
Surgical excision
What is the synonym for Dissecting Cellulitis?
Perifolliculitis capitis abscedens et suffodiens
What is referred to as the ‘follicular occlusion tetrad’?
Dissecting Cellulitis, Hidradenitis suppurativa, Acne conglobata, Pilonidal sinus/cyst
What type of alopecia classification.is associated with Dissecting Cellulitis?
Neutrophilic cicatricial alopecia
What are the initial appearances of nodules in Dissecting Cellulitis?
Scalp nodules appear first then develop into interconnecting, boggy, fluctuant, oval and linear ridges
What are the first-line therapies for Dissecting Cellulitis?
- Isotretinoin
- Oral antibiotics
What is another name for Acne Necrotica?
Necrotizing lymphocytic folliculitis
Also known as Acne necrotica varioliformis.
What is the suggested etiology of Acne Necrotica?
Altered immune reaction to microorganisms within the skin.
What areas of the body are most commonly involved in Acne Necrotica? Who gets it?
- Face
- Scalp
- Neck
- Upper trunk
Adults
What is the typical course duration of Acne Necrotica?
Chronic or recurrent course lasting decades.
How do the lesions of Acne Necrotica initially present?
Umbilicated follicular vesicles or papulovesicles.
What develops over time in Acne Necrotica lesions?
Hemorrhagic crusts and varioliform scars.
What long-term treatments are recommended for Acne Necrotica?
- Antibiotics (e.g. doxycycline)
- Isotretinoin
- Oral corticosteroids when needed.
Where on the body do lesions from Erosive Pustular Dermatosis typically develop?
Demographic?
Central scalp and lower extremities.
Older adults
What type of lesions develops in Erosive Pustular Dermatosis?
Erosions covered with thick keratotic crusts, with purlent discharge when removed
What does trichoscopy reveal in Erosive Pustular Dermatosis?
- Follicular pustules
- Serous exudates
- Black crusts
- Follicular hyperkeratosis
- Absence of follicular openings
What are the histologic findings during the early stage of Erosive Pustular Dermatosis?
- Laminated orthokeratosis
- Psoriasiform hyperplasia of the epidermis
- Mixed inflammatory infiltrates in the dermis
What characterizes late-stage Erosive Pustular Dermatosis in histopath?
- Extensive fibrosis
- Atrophy
- Absence of sebaceous glands
- Moderate mixed inflammatory infiltrates
What is Nonspecific (End-Stage) Cicatricial Alopecia?
Progressive cicatricial alopecia presenting with scalp fibrosis.
