Itch may indicate inflammation in central centrifugal cicatricial alopecia

Key takeaways:

• Central centrifugal cicatricial alopecia (CCCA) is a scarring baldness that mostly affects Black women.
• Higher levels of interleukin-1B were linked with increased itch in patients with CCCA.

NEW ORLEANS —Pruritus could be a reliable indicator of inflammation in central centrifugal cicatricial alopecia, according to a poster presented here.

“[Central centrifugal cicatricial alopecia (CCCA)] is a type of scarring baldness that predominately affects black women,” Aditi Gadre, MS, the 2022-2023 Ethnic Skin Research Fellow at Johns Hopkins University and the study’s lead author, told Healio. “Anecdotally, patients often come in with itching, so we wanted to understand whether that is a sign of inflammation.”

The researchers conducted noninvasive tape stripping in 23 Black women with CCCA and 26 control patients who were each stratified by itch frequency and hair washing frequency.

More scalp pruritus was reported in the patients with CCCA compared with the control group, although the difference was not statistically significant.

Cytokine expression was assessed and patients with CCCA and increased scalp pruritus were associated with higher levels of interleukin (IL)-1B, whereas scalp pruritus was not associated with any cytokines tested in the control patients.

Lower IL-1RA levels were associated with shampooing frequency; however, shampooing frequency was not associated with scalp pruritus in patients with CCCA.

“We should really pay attention when someone with CCCA who has itching comes in complaining about that as a sign of ongoing inflammation,” Gadre told Healio. “If a woman who has known CCCA comes in with an itchy scalp, that could mean their disease might be active and we can go ahead and give them steroid injections or consider stepping up therapy further.”