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White halo seen in most African Americans with central centrifugal cicatricial alopecia

In a retrospective study that examined various dermatoscopic features of central centrifugal cicatricial alopecia in African American patients, a peripilar white halo was identified as highly specific for the condition and an optimal site from which to obtain a biopsy specimen.

Researchers evaluated 153 nonpolarized dermatoscopic images obtained from 51 women with central centrifugal cicatricial alopecia and created a list of dermatoscopic features that were scored for each image and weighted by popularity.

The honeycomb pigmented network was found in all patients, according to the study. The second most common dermatoscopic finding was the peripilar white halo around the emergence of the hairs.

According to the researchers, statistical analysis revealed that peripilar white halo is specific for central centrifugal cicatricial alopecia (CCCA, and this feature is also a strong sign for the diagnosis.

The researchers wrote that the halo is believed to be white gray because the lamellar fibrosis obscures and destroys the normal melanization in the outer root sheath.

In a normal black scalp, the pinpoint white dots are sparse and regularly distributed; in CCCA, the researchers explained, the pinpoint white dots are numerous and usually interspersed with white patches of scarring.

The researchers concluded that a peripilar white halo is a specific and sensitive criterion for the diagnosis of CCCA.

Disclosure: The researchers reported no financial disclosures.