scarring alopecia
Introduction
Introduction to scarring hair loss Cicatricialalopecia (cicatricialalopecia) is a localized alopecia that occurs suddenly in any long-haired part of the body. It refers to the destruction of hair follicles caused by various causes to form scars, resulting in permanent alopecia. The disease is called "Ghosts" and "oily winds". It is characterized by round or oval hair loss spots on the scalp. Because there is no self-consciousness, it is often found inadvertently and by others. It is also noticed that a large amount of hair is lost when combing the hair, and the flaky hair loss area is found. basic knowledge The proportion of illness: 0.03% Susceptible people: no specific people Mode of infection: non-infectious Complications: alopecia areata
Cause
Scarring off-effect
Infection (20%):
Such as head jaundice, purulent sputum, sputum, sputum, folliculitis, lupus vulgaris, leprosy, unexplained skin diseases such as lichen planus, lupus erythematosus, scleroderma, sarcoidosis, hair follicle mucin deposition disease.
Developmental defects (15%):
Part of the cause of the disease is developmental defects caused by congenital genetic defects, such as skin hypoplasia, Conrdi disease, epidermal sputum, sweat tube keratosis, ichthyosis, and keratinization.
Physical factors (15%):
Such as curls, burns, radiation dermatitis.
Pathogenesis
The pathogenesis is still not clear. Many causes of hair follicle damage form scars, resulting in permanent alopecia. In recent years, alopecia areata is more prone to autoimmune diseases. Changes in humoral immunity include non-organ-specific autoantibodies and organs. Specific autoantibodies, anti-smooth muscle antibodies, anti-nuclear antibodies (mainly spotted), anti-mitochondrial antibodies, anti-basement membrane antibodies and rheumatoid factor have been reported, and anti-thyroid antibodies have been reported for organ-specific autoantibodies. Gastric cell antibody, anti-adrenal antibody, etc., the positive rate of autoantibodies is related to the patient's gender, age and severity of the disease. The change of cellular immunity is a large number of lymphocytes infiltrating around the blood vessels and hair bulbs of alopecia areata lesions. The hair follicles in the area have strong HLAI, class II immunoreactivity, and abnormal expression of adhesion molecules involved in hematopoietic cell migration. These changes may be caused by certain stimulating factors such as trauma, neuroinflammation or infection leading to cytokine release, cytokines can Participate in the development of multiple immune responses, leading to hair follicles In particular, the study of various immune factors related to immune regulation in alopecia areata has been remarkable in recent years. Although the above mechanisms are popular, the exact etiology is still unclear and the exact autoantigens and The genetic type of the disease-causing gene, hair loss is still unclear, and the multi-gene inheritance model with different out-of-date rates and performance seems reasonable, but it is still affected by additional hormones and immunity.
Prevention
Scarring hair loss prevention
Prevention: If you are suffering from head lice, you should actively treat it. The towels, combs, pillowcases, hats, etc. used should be exposed to sunlight, hot, scented, washed and boiled. Pay attention to the cleanliness of the skin, take a bath, work on your nails, change your clothes frequently, keep your pillow clean, and correct malnutrition.
1. Maintain a good mood, ensure adequate sleep, and avoid or remove possible causes.
2. Early diagnosis and early treatment.
Complication
Scarring alopecia complications Complications
The disease can be associated with the following diseases:
1. A lesion such as punctate pits, mediastinal and irregular thickening and obvious dystrophy, the change of total baldness and alopecia are particularly significant.
2. Genetic allergic diseases.
3. Autoimmune diseases.
4. Eye diseases such as dilated pupil dilation, eyeball retraction, vascular and pigmentary malformations, crystal opacity and cataract.
5. The incidence of alopecia areata in Down syndrome is 6%.
Symptom
Scarring hair loss symptoms Common symptoms Alopecia areata, wind, dryness, blood, dryness, permanent baldness, lack of blood, alopecia areata, baldness
It is characterized by round or oval hair loss spots on the scalp. Because there is no self-consciousness, it is often found inadvertently and by others. It is also noticed that a large amount of hair is lost when combing the hair, and the flaky hair loss area is found. The disease can be divided into three phases, namely, the onset phase, the stationary phase and the recovery phase. During the period of development, new hair loss spots appear, and the original hair loss spots are enlarged, but the number and size of hair loss spots are different. Most of them are the size of the nail cover to the coin, and the adjacent hair loss spots can be quickly merged. The detached hair shaft is atrophied at the proximal end, dull and dark at the end. The hair around the hair loss spot is loose, easy to pull out, and the root is made into an exclamation mark (!), that is, the hair pull test is positive. This is a feature of the disease in its infancy. The scalp in the hair loss area is normal, no inflammatory redness, no scales, no scars. The hair at the edge of the telogen effusion zone is no longer loose and no new hair loss spots appear. Most patients enter the recovery period after a quiescent period of 3 to 4 months. During the recovery period, new hair grows. It is initially a soft, light-colored fluff, similar to a mane. It gradually turns thick and black and then returns to normal.
Examine
Scarring hair loss examination
The laboratory examination of the disease is mainly for histopathology: generally it is not necessary to do a biopsy, unless the hair loss is diffuse, considering the growth period and rest period hair loss, the typical change is: mononuclear cell infiltration around the hair bulb, perivascular and outer root sheath Mainly for T cells and macrophages, hair follicle atrophy, pigment abnormalities and hair matrix degeneration are also seen.
Diagnosis
Diagnosis of scarring alopecia
Differential diagnosis
1. The symptoms of pseudo-alopecia are similar to alopecia areata, but the skin of the affected part is atrophy, the hair can not be regenerated, the surface has an island-like normal hair bundle, and the edge has a thin and narrow red halo band, and the hair is not loose, which is more common in women aged 30-50 years.
2. The head whitehead is grayish white scaly patch, the hair is broken from the scalp 2~4mm, the outer white fungus sheath, the fungal test is positive, more common in children, black spots, scalp damage is similar to whitehead, but the damage is small. A large number, often accompanied by varying degrees of inflammatory response, the disease often reveals the scalp is broken, non-alopecia, positive for fungal examination, jaundice and alopecia are atrophic scars, which are sparsely scattered in the residual hair, there are fashion typical symptoms of jaundice .
3. Patients with plucking have mental abnormalities, often unconsciously and frequently remove hair, which can be identified according to medical history and clinical manifestations.
4. Leprosy hair loss starts from the hairline and gradually spreads upward. In severe cases, there are flaky or linear hairs along the vascular path. The hair is completely detached from other hairs. In addition to hair loss, there are other damages and paresthesias of leprosy.
5. Alopecia folliculitis first occurs in the hair follicle purulent inflammation, and then atrophic scar, easy to repeat.
6. syphilitic hair loss has a history of syphilis or a history of unclean sexual intercourse, hair loss is worm-like, irregular distribution, hair loss in the hair loss area is not complete, more common in the occipital sac, syphilis serological test positive.
