CENTRAL CENTRIFUGAL CICATRICIAL ALOPECIA: POSSIBLE FAMILIAL AETIOLOGY IN TWO AFRICAN FAMILIES FROM SOUTH AFRICA
Background
Central centrifugal cicatricial alopecia (CCCA) is the most common type of primary scarring alopecia in African American women.1 Cicatricial alopecia is characterised by both the destruction and replacement of the hair follicle by fibrous tissue However CCCA is a distinct form of scarring alopecia characterised by hair loss which starts at the vertex and gradually progresses in a centrifugal pattern. It was, first described in 1968 by Lopresti et al.2 who originally coined it ‘‘hot comb alopecia’’ based on the hypothesis that heat from hot combing was responsible for the alopecia. The term follicular degeneration syndrome was later proposed by Sperling and Sau in 1992, as they found no etiological relationship between use of a hot comb and the scarring alopecia.3 Then Headington4 proposed scarring alopecia in African Americans, and Sperling denominated it central centrifugal scarring alopecia.5 Finally, the term central centrifugal cicatricial alopecia was adopted by the North American Hair Research Society6 in 2001.