Scarring Alopecias: What are the similarities?

What are the similarities?

The scarring alopecias are a diverse group of conditions. Taken together, there are well over 100 scarring alopecias although a group of 6 or 7 comprise the most common ones.

Lichen planopilaris (LPP), frontal fibrosing alopecia (FFA), pseudopelade (PPB), central centrifugal cicatricial alopecia (CCCA) and discoid lupus (DLE) are examples of these more common entities.

Modern research has shown there are many differences between these conditions. However they may have important similarities. For example, intense research into the basic causes of lichen planopilaris (LPP) have shown that the formation of “toxic” lipids in the hair follicle may lead to destruction of the oil glands (sebaceous glands), inflammation and ultimately destruction of the hair follicle. Certain signalling pathways inside the hair follicle, such as the PPAR gamma pathway may be important not only in LPP but other scarring hair loss conditions as well. Reduced levels of PPAR may be seen in LPP as well as FFA and CCCA and possibly others as well.

These similarities are important to explore further as they may enable many clinically distinct scarring alopecias to be treated similarly.