Central Centrifugal Cicatricial Alopecia in Males : New Report Highlights Features in 17 males

Features of CCCA in Males 

A new study in the Journal of the American Academy of Dermatology discussed the features of CCCA in male patients. The authors identified 17 males with a diagnosis of CCCA. Patient ages ranged from 30 to 72 years. Most of the patients were black or African American.

Most patients  (82.4%) did not report history of potential high-risk hair care practice such as use of relaxers or braids or cornrows. 2 patients reported a history of locs, braids, or cornrows. 1 patient had a history of chemical relaxer or texturizer use, and one had a history of permanent hair coloring.

None of the patients had diagnosis of type 2 diabetes, a risk factor that has been suggested to possibly be present in some women with CCCA. 3 patients (17.6% of cases) had history of latent tuberculosis (TB)  

The location was classic in 8 patients, but several patients had an atypical location including  3 occipital,  2 posterior vertex, 2 patchy, 1 diffuse, and 1 undetermined. Inflammatory symptoms were often present. 10 patients (58.8%) had pruritus, 3 (17.6%) had bleeding, 2 (11.8%) had erythema and 4 (23.5%) had scalp pain or tenderness.

Pathology showed typical findings of loss of sebaceous glands, perifollicular fibrosis, perifollicular inflammation and eccentric thinning of the outer root sheath.

This paper is similar to another recently published paper of 3 males with CCCA

Summary

This is an interesting report and reminds us all to keep CCCA in the differential for black males with symptomatic central and vertex hair loss. This case series also reminds us that atypical hair loss patterns may be present including involvement of the involvement of the lateral sides and posterior scalp.  

REFERENCE

Jackson TK et al. Central Centrifugal Cicatricial Alopecia in Males. J Am Acad Dermatol. 2023 Jul 24:S0190-9622(23)02399-X. doi: 10.1016/j.jaad.2023.07.1011. Online ahead of print.