Search Our Scientific Publications & Authors

Biomedicines 2021 Nov 24;9(12). Epub 2021 Nov 24.

The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester M6 8HD, UK.

Primary cicatricial alopecias (PCA) represent a challenging group of disorders that result in irreversible hair loss from the destruction and fibrosis of hair follicles. Scalp skin biopsies are considered essential in investigating these conditions. Unfortunately, the recognised complexity of histopathologic interpretation is compounded by inadequate sampling and inappropriate laboratory processing. Read More

Hautarzt 2021 Oct 21;72(10):855-859. Epub 2021 Apr 21.

Klinik für Dermatologie und Allergologie, Städtisches Klinikum Dresden, Friedrichstr. 41, 01067, Dresden, Deutschland.

Tinea capitis is seen world-wide among children up to 12 years. The most severe type is Kerion Celsi with painful abscesses and lymphadenopathy. We report on an 11-year-old boy with Kerion Celsi, who was initially treated using antibiotics under the common misdiagnosis of a bacterial infection. Read More

Skin Appendage Disord 2019 Feb 5;5(2):65-71. Epub 2018 Sep 5.

Department of Dermatology and Dermatopathology, University of California-Irvine, Irvine, California, USA.

Importance: Hair loss, or alopecia, is one of the most commonly presented problems in dermatology. Scarring alopecias are considered particularly damaging due to limited success in slowing permanent disease progression, and current treatment methods, such as intralesional and topical steroids and topical minoxidil, are largely ineffective.

Objective: Hair transplantation is a debated treatment option for advanced cases of primary scarring alopecia. Read More

Indian J Pathol Microbiol 2019 Jan-Mar;62(1):103-106

Department of Dermatology, Maulana Azad Medical College, New Delhi, India.

Objectives: To study the direct immunofluorescence (DIF) in cicatricial alopecia (CA) patients.

Materials And Methods: Approximately, 155 skin biopsies from CA patients examined over 7 years (2009-2015). Special stains and Hematoxylin and Eosin were performed, and final histopathological diagnosis was made. Read More

J Dermatol 2018 Apr 16;45(4):450-455. Epub 2018 Jan 16.

Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Primary scarring alopecia (PSA) is caused by irreversible damage to the hair epithelial stem cells that reside in hair follicles. There is limited published work regarding PSA amongst the Asian population. The aim of this study was to evaluate the clinical features and to characterize the subtypes of PSA in southern Taiwan. Read More

Int J Trichology 2017 Jul-Sep;9(3):113-115

Department of Leprosy, Pramukshwami Medical College, Karamsad, Gujarat, India.

Pseudopelade of Brocq (PPB) is a rare, chronic, slowly progressive cicatricial alopecia that generally affects middle-aged women. Vertex and parietal scalp are commonly involved. It can be primary or secondary to end stage of other scarring alopecia such as lichen planopilaris and discoid lupus erythematosus. Read More

J Am Acad Dermatol 2016 Dec;75(6):1101-1117

Department of Dermatology, University of British Columbia, Vancouver, British Columbia, Canada; Department of Dermatology, New York University, New York, New York.

Primary cicatricial alopecias can be frustrating for both patients and physicians. Proper diagnosis guides more successful management of these challenging conditions. Part II will cover the remaining lymphocytic primary cicatricial alopecias, which include pseudopelade of Brocq, central centrifugal cicatricial alopecia, alopecia mucinosa, and keratosis follicularis spinulosa decalvans. Read More

Int J Trichology 2015 Jul-Sep;7(3):107-12

Department of Pathology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, Meghalaya, India.

Background: The primary cicatricial alopecias (PCAs) are a rare group of diseases where hair follicle is the primary target of destruction. There are a few studies on histopathological and trichoscopic features of PCA.

Aims: To study the clinical, trichoscopic, and histopathological characteristics of PCAs of the scalp and to find out the concordance between trichoscopic and histopathological diagnosis. Read More

Curr Probl Dermatol 2015 20;47:76-86. Epub 2015 Feb 20.

Scarring alopecia or cicatricial alopecia results from follicular damage that is sufficient to cause the destruction and replacement of pilosebaceous structures by scar tissue. Primary scarring alopecias represent a group of disorders that primarily affect the hair follicles, as opposed to secondary scarring alopecias, which affect the dermis and secondarily cause follicular destruction. Inflammation may predominantly involve lymphocytes or neutrophils. Read More

Actas Dermosifiliogr 2015 May 24;106(4):260-70. Epub 2014 Oct 24.

Servicio de Dermatología, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, España. Electronic address:

The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. Read More

Int J Trichology 2014 Apr;6(2):54-62

Department of Dermatology, Venereology and Leprosy, Government Medical College Bhavnagar, Sir Takhtasinh General Hospital Campus, Bhavnagar, Gujarat, India.

Aims: The aim was to study the trichoscopy features of selected hair and scalp conditions by two dermoscopic devices with different modes that is, polarized (noncontact) and nonpolarized (contact) mode.

Materials And Methods: The present study included 11 clinical varieties of cases with total 112 patients, attending Sir Takhtasinh Hospital, Bhavnagar in the last 2 years. The clinical history was recorded for each case, and images were taken in both the Heine and DermLite II pro dermatoscope. Read More

Int J Trichology 2014 Jan;6(1):27-30

Department of Dermatology and Venereology, Pramukhswami Medical College, Karmasad, Gujarat, India.

Pseudopelade of Brocq (PPB) is a rare, idiopathic self-limiting hair disorder resulting in progressive cicatricial alopecia primarily involving the parietal scalp and vertex. The general pathogenesis of scarring alopecias has been focused on theories of stem cell failure and sebaceous gland destruction. Acquired immunity, Borrelia infection and senescence of follicular stem cell reservoir plays suspected role. Read More

Indian J Dermatol Venereol Leprol 2014 Jul-Aug;80(4):306-12

Department of Dermatology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China.

Background: There have been few reports on primary cicatricial alopecias (PCR) especially from Asia (PCA).

Aims: To study the clinical, pathological and dermoscopic characteristics of PCA among Chinese patients.

Methods: A retrospective analysis of the clinical data of 59 patients with PCA was conducted and the dermoscopic, pathological, treatment and prognosis characteristics analyzed. Read More

Ann Dermatol 2014 Apr 30;26(2):214-20. Epub 2014 Apr 30.

Department of Dermatology, Pusan National University School of Medicine, Busan, Korea. ; Medical Research Institute, Pusan National University School of Medicine, Busan, Korea.

Background: Various kinds of alopecia can show small round or oval hairless patch. Dermoscopy could be a simple, useful tool for making a correct diagnosis.

Objective: The aim of this study is to investigate clinical usefulness of dermoscopy for diseases with small round or oval hairless patch on the scalp. Read More

Pak J Biol Sci 2013 Nov;16(22):1609-11

Student Research Committee, Tabriz University of Medical Sciences, Iran.

Cicatricle alopecia represents a diverse group of diseases characterized by a lack of follicular ostia and irreversible alopecia. This study aimed at evaluating cicatricial alopecia in Iranian patients. One hundred patients with cicatricial alopecia were studied. Read More

Clin Dermatol 2013 Nov-Dec;31(6):759-63

Sector of Dermatology and Post-Graduation Course, School of Medicine and University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address:

We discuss three controversial situations related to disorders of hair growth and the pilosebaceous unit: alopecia areata incognita, pseudopelade of Brocq, and the association of psoriasis and alopecia. Read More

Facial Plast Surg Clin North Am 2013 Aug;21(3):325-34

Private Practice, 701 Metairie Road, Suite 2A205, Metairie, LA 70005, USA. Electronic address:

It is crucial that hair restoration surgeons understand the basic clinical diagnosis and pathologic condition of other hair loss conditions that are not always amenable to successful hair transplantation. In this article nonscarring and scarring mimickers of androgenetic alopecia are discussed. Nonscarring conditions include alopecia areata, telogen effluvium, and tinea capitis. Read More

Indian J Dermatol Venereol Leprol 2012 Sep-Oct;78(5):637-40

Ann Dermatol Venereol 2011 May 26;138(5):430-3; quiz 429, 434. Epub 2011 Feb 26.

Departements of Dermatology, Allergology and Venereology, Institute of Clinical Medicine, University of Helsinki, Finland.

Ann Dermatol Venereol 2011 May;138(5):373-4

Cutis 2010 Oct;86(4):187-9

Department of Dermatology, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.

We report a case of a white woman with discrete, asymmetrical, noninflammatory areas of hair loss clinically suggestive of pseudopelade of Brocq (PB). However, the histologic features revealed a diagnosis of alopecia areata (AA). We discuss the importance of histopathologic examination in the diagnosis of AA. Read More

Histopathology 2010 Jan;56(1):24-38

Department of Dermatopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK.

Interpretation of the histopathological findings of primary scarring and non-scarring alopecias may prove daunting. This is especially true if the biopsy specimen is inadequate, and the clinical history and pattern of the alopecia are not known. Common forms of scarring alopecias discussed here are the lymphocytic (discoid lupus erythematosus, lichen planopilaris, central centrifugal cicatricial alopecia, pseudopelade of Brocq), the neutrophilic (folliculitis decalvans, dissecting folliculitis), and the mixed (acne keloidalis) entities. Read More

J Dermatol Sci 2010 Jan 22;57(1):27-36. Epub 2009 Nov 22.

Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada.

Background: Lichen planopilaris (LPP) and pseudopelade of Brocq (PPB) are two scarring alopecia diagnoses that exhibit similar clinical features. Some suggest LPP and PPB are not distinct diseases, but rather different clinical presentations in a spectrum derived from the same underlying pathogenic mechanism.

Objective: We explored the degree of similarity between LPP and PPB gene expression patterns and the potential for common and unique gene pathway and gene activity in LPP and PPB using microarrays. Read More

Clinics (Sao Paulo) 2008 Dec;63(6):747-52

Department of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.

Background: Scarring alopecias are classified into primary and secondary types according to the initial site of inflammation. In primary scarring alopecias, the hair follicle is the main target of destruction; the term secondary cicatricial alopecia implies that follicular destruction is not the primary pathologic event.

Aims: To review the histopathologic diagnoses of cases of cicatricial alopecia in order to classify them according to the North American Hair Research Society. Read More

Dermatol Ther 2008 Jul-Aug;21(4):257-63

Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.

Pseudopelade of Brocq (PPB) is a rare, idiopathic, slowly progressive hair disorder, resulting in cicatricial alopecia. It typically presents in Caucasian adult patients as small, smooth, flesh-toned and slightly depressed alopecic patches with irregular outlines. It primarily involves the parietal and vertex portions of the scalp with a chronic prolonged course. Read More

Skinmed 2008 Jan-Feb;7(1):19-26

Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada.

In this 2-part article, the authors review the primary cicatricial alopecias. Primary cicatricial alopecia can be defined as predominantly lymphocytic, neutrophilic, or mixed based on the nature of the follicular infiltrate that is present around affected hair follicles. Lymphocytic primary cicatricial alopecias include chronic cutaneous lupus erythematosus (discoid lupus erythematosus), lichen planopilaris, classic pseudopelade of Brocq, central centrifugal cicatricial alopecia, alopecia mucinosa, and keratosis follicularis spinulosa decalvans. Read More

Acta Dermatovenerol Croat 2006 ;14(4):246-52

University Department of Dermatology and Venereology, Sestre milosrdnice University Hospital, Zagreb, Croatia.

There are numerous dermatoses which may cause cicatricial alopecia when localized on the scalp, such as chronic discoid lupus erythematosus (DLE), lichen planus, graft-versus-host disease, dermatomyositis, scleroderma, cicatricial pemphigoid, porphyria cutanea tarda, follicular mucinosis, perifolliculitis capitis abscedens, lichen sclerosus et atrophicus, necrobiosis lipoidica, sarcoidosis, etc. Histologically, cicatricial alopecia is characterized by dermal scarring, along with absent or reduced hair follicles and reduced number of erector pili muscles. According to working classification of cicatricial alopecia by the North American Hair Society, primary cicatricial alopecia may be divided into the following categories: lymphocytic group (e. Read More

Dermatology 2005 ;211(2):98-102

Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.

Background: There are diverse causes of cicatricial alopecia characterized by lack of follicular ostia and irreversible loss of hair. While clinical differentiation between the causes may be difficult, particularly with regard to lichen planus (LP), lupus erythematosus (LE) and pseudopelade of Brocq (PB), it has been suggested that both histopathologic examination and direct immunofluorescence studies (DIF) are necessary for an accurate diagnosis.

Objective: The aim of this study was to evaluate the diagnostic value of DIF studies in addition to histopathology in patients with cicatricial alopecia as a clinical feature. Read More

J Am Acad Dermatol 2005 Apr;52(4):637-43

University of California, San Francisco, San Francisco, California, USA.

Background: Primary cicatricial alopecias encompass a group of disorders characterized by permanent destruction of the hair follicle. The varied clinical features and differences in terminology have led to difficulties in defining consistent clinicopathologic correlation.

Objective: We sought clinicopathologic correlation of 6 clinically distinct primary cicatricial alopecias: lichen planopilaris, frontal fibrosing alopecia, pseudopelade (Brocq), central centrifugal alopecia, folliculitis decalvans, and tufted folliculitis. Read More

Lupus 2004 ;13(6):455-62

Second Dermatology Clinic, Department of Dermatological Sciences, University of Florence, Florence, Italy.

Scarring alopecia is a very frequent feature of chronic discoid lupus erythematosus (DLE). So far in the literature, only clinic-pathologic features or histopathologic-immunopathologic traits of DLE scarring alopecia (DLESA) have been reported. We describe the most significant features of clinical morphology, histopathology, serum and tissue immunopathology of 36 DLESA patients (41. Read More