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Central centrifugal cicatricial alopecia(CCCA)

MedGen UID:: 698033
•Concept ID:: C1274708
•: Disease or Syndrome

Synonym:	CCCA
SNOMED CT:	Central centrifugal cicatricial alopecia (109441000119102); Hot comb alopecia (109441000119102)

Monarch Initiative:	MONDO:0022113
OMIM®:	618352

Definition

Central centrifugal cicatricial alopecia (CCCA) is the most common type of primary scarring alopecia affecting women of African ancestry, with an estimated prevalence of 2.7 to 5.6%. It may be triggered by hair-grooming habits; however, familial occurrence has been reported. Mean age at presentation is 36 years. The first sign is often unexplained hair breakage, followed by hair thinning, primarily involving the vertex scalp and progressing centrifugally. Histopathologic examination shows varying degrees of lymphocytic inflammation, follicular degeneration, and fibrosis (Malki et al., 2019). [from OMIM]

Clinical features

From HPO

Scarring alopecia of scalp

MedGen UID:: 812631
•Concept ID:: C3806301
•: Finding

See: Feature record | Search on this feature

Abnormality of head or neck
- Scarring alopecia of scalp

Professional guidelines

PubMed

Review of the use of Janus kinase inhibitors in the treatment of scarring alopecia.

Nohria A, Desai D, Shapiro J, Bordone L, Lo Sicco K
Int J Dermatol 2024 Jun;63(6):e105-e110. Epub 2024 Apr 3 doi: 10.1111/ijd.17153. PMID: 38571280

Treatment for central centrifugal cicatricial alopecia-Delphi consensus recommendations.

Jackson T, Sow Y, Dinkins J, Aguh C, Omueti Ayoade K, Barbosa V, Burgess C, Callender V, Cotsarelis G, Grimes P, Harvey V, Kindred C, Lester J, Lo Sicco K, Mayo T, McMichael A, Oboite M, Ogunleye T, Olsen E, Osei-Tutu A, Piliang M, Senna M, Shapiro J, Tosti A, Frey C, Adotama P, Taylor SC
J Am Acad Dermatol 2024 Jun;90(6):1182-1189. Epub 2024 Feb 9 doi: 10.1016/j.jaad.2023.12.073. PMID: 38341148

Use of low-level light therapy in management of central centrifugal cicatricial alopecia: A case series of four patients.

Cook MK, Feaster BN, Subash JJ, Larrondo J, McMichael AJ
Photodermatol Photoimmunol Photomed 2023 Nov;39(6):673-675. Epub 2023 Aug 23 doi: 10.1111/phpp.12905. PMID: 37612840

See all (11)

Recent clinical studies

Etiology

Low-Dose Metformin and Profibrotic Signature in Central Centrifugal Cicatricial Alopecia.

Bao A, Qadri A, Gadre A, Will E, Collins D, Ahima R, Bordone LA, Aguh C
JAMA Dermatol 2024 Nov 1;160(11):1211-1219. doi: 10.1001/jamadermatol.2024.3062. PMID: 39230880 Free PMC Article

Central centrifugal cicatricial alopecia in males.

Jackson TK, Sow Y, Ayoade KO, Seykora JT, Taylor SC, Ogunleye T
J Am Acad Dermatol 2023 Dec;89(6):1136-1140. Epub 2023 Jul 24 doi: 10.1016/j.jaad.2023.07.1011. PMID: 37495175

Comorbidities in patients with central centrifugal cicatricial alopecia: A retrospective chart review of 53 patients.

Leung B, Lindley L, Reisch J, Glass DA 2nd, Ayoade K
J Am Acad Dermatol 2023 Feb;88(2):461-463. Epub 2022 Jun 15 doi: 10.1016/j.jaad.2022.06.013. PMID: 35716835

Increased risk of vitamin D deficiency and insufficiency in Black patients with central centrifugal cicatricial alopecia.

Collins MS, Ali S, Wiss IP, Senna MM
J Am Acad Dermatol 2022 Sep;87(3):689-691. Epub 2022 Feb 15 doi: 10.1016/j.jaad.2022.02.018. PMID: 35176399

Advances and challenges in hair restoration of curly Afrocentric hair.

Rogers NE, Callender VD
Dermatol Clin 2014 Apr;32(2):163-71. doi: 10.1016/j.det.2013.12.004. PMID: 24680003

See all (51)

Diagnosis

Treatment for central centrifugal cicatricial alopecia-Delphi consensus recommendations.

Scarring Alopecia.

Larrondo J, McMichael AJ
Dermatol Clin 2023 Jul;41(3):519-537. Epub 2023 Apr 14 doi: 10.1016/j.det.2023.02.007. PMID: 37236719

Central Centrifugal Cicatricial Alopecia.

Heath CR, Usatine RP
Cutis 2022 Apr;109(4):235-236. doi: 10.12788/cutis.0490. PMID: 35659847

Fibrosing alopecia in a pattern distribution.

Griggs J, Trüeb RM, Gavazzoni Dias MFR, Hordinsky M, Tosti A
J Am Acad Dermatol 2021 Dec;85(6):1557-1564. Epub 2020 Jan 8 doi: 10.1016/j.jaad.2019.12.056. PMID: 31926219

Central Centrifugal Cicatricial Alopecia.

Aguh C, McMichael A
JAMA Dermatol 2020 Sep 1;156(9):1036. doi: 10.1001/jamadermatol.2020.1859. PMID: 32745206

See all (67)

Therapy

Low-Dose Metformin and Profibrotic Signature in Central Centrifugal Cicatricial Alopecia.

Bao A, Qadri A, Gadre A, Will E, Collins D, Ahima R, Bordone LA, Aguh C
JAMA Dermatol 2024 Nov 1;160(11):1211-1219. doi: 10.1001/jamadermatol.2024.3062. PMID: 39230880 Free PMC Article

Updates on disorders in curly hair.

Geisler AN, Taye M, Larrondo J, Mayo TT, Aguh C, McMichael A, MacKelfresh JB, Krueger L
Int J Dermatol 2024 Sep;63(9):1145-1154. Epub 2024 Apr 15 doi: 10.1111/ijd.17184. PMID: 38622785

Safety and Efficacy of Minoxidil Treatment in Scarring Alopecia: A Scoping Review.

Ly N, McClure EM, Hordinsky MK, Farah RS, Park SY
J Drugs Dermatol 2024 Mar 1;23(3):146-151. doi: 10.36849/jdd.7743. PMID: 38443124

Central Centrifugal Cicatricial Alopecia.

Aguh C, McMichael A
JAMA Dermatol 2020 Sep 1;156(9):1036. doi: 10.1001/jamadermatol.2020.1859. PMID: 32745206

Ethnic hair disorders.

Lindsey SF, Tosti A
Curr Probl Dermatol 2015;47:139-49. Epub 2015 Feb 20 doi: 10.1159/000369414. PMID: 26370652

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Prognosis

Central Centrifugal Cicatricial Alopecia Associated With PDL1 Loss and Increased Expression of Caspase 3: A Case Series.

Smith SDB, Woddor N, Cassarino DS, Chen W, Clemetson N, Nava VE
Am J Dermatopathol 2023 Jun 1;45(6):418-422. Epub 2023 Apr 10 doi: 10.1097/DAD.0000000000002428. PMID: 37074004

Update on trichoscopy: Integration of the terminology by systematic approach and a proposal of a diagnostic flowchart.

Kinoshita-Ise M, Sachdeva M
J Dermatol 2022 Jan;49(1):4-18. Epub 2021 Nov 22 doi: 10.1111/1346-8138.16233. PMID: 34806223

Variant PADI3 in Central Centrifugal Cicatricial Alopecia.

Malki L, Sarig O, Romano MT, Méchin MC, Peled A, Pavlovsky M, Warshauer E, Samuelov L, Uwakwe L, Briskin V, Mohamad J, Gat A, Isakov O, Rabinowitz T, Shomron N, Adir N, Simon M, McMichael A, Dlova NC, Betz RC, Sprecher E
N Engl J Med 2019 Feb 28;380(9):833-841. Epub 2019 Feb 13 doi: 10.1056/NEJMoa1816614. PMID: 30763140

Association of Uterine Leiomyomas With Central Centrifugal Cicatricial Alopecia.

Dina Y, Okoye GA, Aguh C
JAMA Dermatol 2018 Feb 1;154(2):213-214. doi: 10.1001/jamadermatol.2017.5163. PMID: 29282458 Free PMC Article

A systematic approach to Afro-textured hair disorders: dermatoscopy and when to biopsy.

Yin NC, Tosti A
Dermatol Clin 2014 Apr;32(2):145-51. Epub 2014 Jan 11 doi: 10.1016/j.det.2013.11.005. PMID: 24680001

See all (15)

Clinical prediction guides

Central centrifugal cicatricial alopecia in males.

Jackson TK, Sow Y, Ayoade KO, Seykora JT, Taylor SC, Ogunleye T
J Am Acad Dermatol 2023 Dec;89(6):1136-1140. Epub 2023 Jul 24 doi: 10.1016/j.jaad.2023.07.1011. PMID: 37495175

Update on trichoscopy: Integration of the terminology by systematic approach and a proposal of a diagnostic flowchart.

Kinoshita-Ise M, Sachdeva M
J Dermatol 2022 Jan;49(1):4-18. Epub 2021 Nov 22 doi: 10.1111/1346-8138.16233. PMID: 34806223

Variant PADI3 in Central Centrifugal Cicatricial Alopecia.

A systematic approach to Afro-textured hair disorders: dermatoscopy and when to biopsy.

Yin NC, Tosti A
Dermatol Clin 2014 Apr;32(2):145-51. Epub 2014 Jan 11 doi: 10.1016/j.det.2013.11.005. PMID: 24680001

Pigmented casts.

Miteva M, Romanelli P, Tosti A
Am J Dermatopathol 2014 Jan;36(1):58-63. doi: 10.1097/DAD.0b013e3182919ac7. PMID: 23823025

See all (22)