A proposed mechanism for central centrifugal cicatricial alopecia

Exp Dermatol. 2020 Feb;29(2):190-195. doi: 10.1111/exd.13664. Epub 2018 Jun 29.


Central centrifugal cicatricial alopecia (CCCA) has an unknown mechanism. Analyzing other scarring diseases (lichen planopilaris, fibrotic kidney disease and scleroderma) may help to clarify the mechanism of scarring in CCCA. These diseases were chosen for comparison due to either their location of disease (skin or scalp specifically), or prominence in patients of African descent. Genetics, possible triggers, an autoimmune lymphocytic response, and epithelial to mesenchymal transition are potentially involved. Possible common pathways in scarring diseases and a better understanding of the CCCA mechanism will lead to further research into the pathogenesis and potential treatments of CCCA.

Keywords: African-American; hair loss; mechanism; pathogenesis; scarring.

Publication types

  • Letter
  • Review

MeSH terms

  • Alopecia / etiology*
  • Alopecia / pathology*
  • Cicatrix / etiology*
  • Cicatrix / pathology
  • Fibrosis / etiology
  • Humans
  • Kidney / pathology
  • Kidney Diseases / etiology*
  • Kidney Diseases / pathology
  • Lichen Planus / etiology*
  • Lichen Planus / metabolism
  • PPAR gamma / metabolism
  • Scalp
  • Scleroderma, Systemic / etiology*


  • PPAR gamma