Cicatricial alopecia: Clinical, dermascopy and histopathological study

INTRODUCTION: Cicatricial alopecia is a scarring form of Alopecia due to permanent destruction of hair follicles. It can be of Primary or Secondary cause. Cicatricial alopecia leads to considerable disfigurement of the scalp which can be a major psychosocial burden. This study is conducted to emphasize on the early diagnostic features based on clinical, dermascopic and histopathological findings and identifying the underlying cause of cicatricial alopecia. AIM OF THE STUDY: To determine in the cases of cicatricial alopecia the following: 1. To study the clinical pattern of the disease. 2. To study the dermascopic features of the disease. 3. To study the histopathological findings of the disease. 4. To identify various etiological causes of the disease. MATERIALS AND METHODS: Study Design : Prospective cohort study. Sample : 50 cases. METHODS: This study was carried from November 2016 to September 2017 in Rajiv Gandhi Govt. General Hospital. Detailed clinical history was obtained.Clinical and Dermascopy examination was done. Scalp biopsy was done and sent for histopathology. Routine investigations of all patients were performed for all. RESULTS: In my study, it was seen that maximum number of cases of cicatrical alopecia were of LPP (30%) followed by 26% of DLE. Amongst the less frequent causes were Non specific cicatricial alopecia (8%)and Pseudo pelade of Brocq (6%) acne keloidalis nuchae (4%), keratosis spinulosa declavans and systemic lupus erythematoses 2% each. Amongst the secondary causes of cicatricial alopecia trauma was the most common (4%) followed by 2% each of radiation, lipoid proteinosis, Gunthers disease, and scalp tumors. In dermascopic features absent follicular opening was seen in almost all patients. Commonest histopathological feature of cicatricial alopecia was follicular plugging (18%) followed by basal cell vacuolization and hyperkeratosis (16%) each. CONCLUSION: Scalp hair is a significant cosmetic element and prompt diagnosis and aggressive management is crucial in preventing permanent disfigurement. Dermatoscopy provides a useful aid for the diagnosis of cicatricial alopecia