Abstract

Objective: Primary cicatricial alopecias (PCAs) are a group of rare dermatological disorders characterized by irreversible destruction of hair follicles due to inflammatory processes, leading to permanent hair loss. The diagnostic process is often delayed due to nonspecific clinical presentation and overlapping histopathological features.This study aims to analyze the clinical and histopathological characteristics of PCA subtypes diagnosed over a 17-year period in a tertiary dermatology clinic in Türkiye.
Methods: A retrospective analysis was conducted on 116 histopathologically confirmed PCA cases between 2008 and 2025. Clinical diagnoses included discoid lupus erythematosus (DLE), lichen planopilaris (LPP), frontal fibrosing alopecia (FFA), pseudopelade of Brocq (PPB), and folliculitis decalvans (FD). Histopathological features were systematically reviewed and statistically analyzed using SPSS v25.0.
Results: The most frequent subtype was DLE (60,3%), followed by LPP (28,4%). DLE was associated with basal membrane thickening (82,9%) and dermal mucin deposition (71,4%), while LPP showed higher rates of sebaceous gland loss (51,5%) and interface dermatitis (54,5%). FFA exhibited overlapping features with LPP, including 100% basal cell degeneration. Statistically significant associations were found between specific histopathological patterns and clinical subtypes .
Conclusion: This study provides one of the most comprehensive PCA datasets in Türkiye, highlighting distinct histopathological patterns associated with specific clinical subtypes. These findings underscore the importance of clinicopathological correlation in PCA diagnosis and contribute valuable data for improving diagnostic accuracy and patient management.

Key words: Cicatricial Alopecia, Lichen Planopilaris, Discoid Lupus Erythematosus, Histopathology, Scalp Diseases