Primary scarring alopecias. A literature review

Abstract

Introduction: scarring alopecias are a group of scalp disorders that result in permanent hair loss due to the destruction of the hair follicle and its replacement by scar tissue. They are usually focal or circumscribed, meaning that they can affect specific areas of the scalp, but some diffuse forms have also been described that can extend over a larger area.

Objective: to provide a complete and up-to-date understanding of the etiology, underlying pathophysiological mechanisms and available treatments for these diseases.

Methods: in this research an exhaustive search for updated information in electronic databases such as Pubmed, Scopus, Clinical Key and Web of Science was carried out taking into account scientific articles of medical relevance and books recognized within the scientific community.

Development: genetic factors, autoimmunity, chronic inflammation and disruption of the normal hair follicle cycle are part of the pathophysiology of primary cicatricial alopecias. Recent research has shown that patients with lichen planus pilaris and frontal fibrosing lichen planus pilaris have alterations in the bacterial composition of the skin.

Conclusions: for proper management and prevention of further damage, it is essential to identify primary scarring alopecias early and accurately. However, due to the overlapping clinical and pathologic features between the different forms of primary scarring alopecia, differential diagnosis can be difficult.