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December 2019 - Hair and Nail Papers 2019

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Research letter

Association of cicatricial alopecia with chemical hair straightening

D.H. Marks D. Hagigeorges J.‐P. Okhovat A.J. Manatis‐Lornell A.J. McMichael M.M. Senna

British Journal of Dermatology (2019) 181, pp1303-1342

https://doi.org/10.1111/bjd.18217

 

This study aimed to quantify the categorical and cumulative exposure of chemical hairstyling practices in patients with cicatricial alopecia.

The authors performed a retrospective review of 1018 patients presenting to an alopecia clinic from July 2017 to December 2018. Patients with a primary cicatricial alopecia and age, sex and ethnicity matched controls with noncicatricial alopecia were included. Patients were asked if they had ever engaged in chemical hair colouring, straightening and perming, if yes, the number of years and the number of times per year they received each type of styling were documented. The cumulative exposure was then defined in ‘practice years’, the product of the number of times each styling practice was undertaken per year and the total number of years performed.

In total, 143 patients with cicatricial alopecia and 143 patients with noncicatricial alopecia were analysed. Within the cicatricial group, 74% of patients had lichen planopilaris (LPP)/FFA and 14% had CCCA. Within the noncicatricial group, patients had androgenetic alopecia (68%), telogen effluvium (33%) and/or alopecia areata (18%).

The data analysed showed patients with cicatricial alopecia were significantly more likely to report any previous chemical hair straightening than patients with noncicatricial alopecia (25% vs.13%, P = 0.018). Patients with LPP/FFA were significantly more likely than matched controls to report chemical straightening (21% vs. 10%, P = 0.026). While a higher prevalence of chemical straightening in patients with CCCA vs. controls did not show a statistical significance (42% vs. 29%, P = 0.43). However, patients with CCCA reported significantly more chemical straightening cumulative exposure than controls (102 practice years vs. 5 practice years, P = 0.04). There was no statistically significant difference found in chemical straightening cumulative exposure between LPP/FFA patients and controls (10 practice years vs. 7 practice years, respectively). No association was identified with hair colouring or perming.

The study was limited by its retrospective nature; small, young sample, patient recall bias and other hair styling techniques and behaviours were not captured.

The author suggest obtaining cumulative lifetime exposure data on hairstyling practices to aid further understanding of the potential association of cicatricial alopecia with chemical hair straightening.

 

Image Correspondence

Image Gallery: A case of onychomatricoma with typical clinical, dermoscopic and histopathological findings

X.‐K. Zou J. Yu S.‐X. Yang.

British Journal of Dermatology (2019) 181, ppe 146.

https://doi.org/10.1111/bjd.18347

 

This article discusses a case of a 31‐year‐old woman who presented with a 4‐year history of asymptomatic thickening and dystrophy on her right third fingernail. The clinical and dermoscopic features were consistent with onychomatricoma. Avulsion of the nail plate revealed filamentous tumour emerging from the nail matrix. The tumour was shaved and histopathological examination confirmed the clinical diagnosis. Follow‐up for 11 months showed no recurrence.

 

 

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