Central centrifugal scarring alopecia (Q98583)

This condition begins as a focus of cicatricial alopecia over the vertex of the scalp in black women. It then gradually spreads outwards in a centrifugal pattern but remains as a single patch. Hair follicle destruction is severe and results in extensive fibrosis, often with granulomatous inflammation around fragments of residual hair. Most patients are middle-aged black females who chemically straighten their hair. The alopecia is slowly progressive and the symmetrical forward progression follows a pattern similar to female pattern hair loss. A possible relationship to hair-straightening procedures is postulated but not conclusively proven.