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Research Letter
July 1, 2020

Dermatoscopic Evaluation of Central Centrifugal Cicatricial Alopecia Beyond the Vertex Scalp

Author Affiliations
  • 1Department of Dermatology, Wake Forest University School of Medicine, Winston Salem, North Carolina
  • 2Department of Dermatology, Clinica Erasmo, Cesar, Colombia
  • 3Department of Dermatology, Emory University Hospital, Atlanta, Georgia
JAMA Dermatol. Published online July 1, 2020. doi:10.1001/jamadermatol.2020.1287

Central centrifugal cicatricial alopecia (CCCA) is a scarring alopecia commonly seen in African American individuals.1 It classically affects the vertex scalp, although 1 study2 suggests that it may manifest as patchy hair loss beyond the vertex. In that study, the histopathologic, dermatoscopic, and clinical findings were crucial in diagnosis. However, another study3 reported histopathologic changes in the vertex scalp consistent with CCCA even without clinically visible hair loss. Our study explored dermatoscopic and histopathologic findings in areas of the scalp without clinically active disease, specifically beyond the vertex scalp. We also assessed the reliability of dermatoscopy, which may serve as a less invasive diagnostic tool than biopsy, for the diagnosis of CCCA in the context of subclinical disease.

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