Central Centrifugal Cicatricial Alopecia Not Linked to Comorbidities

In contrast to previous findings, central centrifugal cicatricial alopecia (CCCA) was not associated with any comorbidities.

Central centrifugal cicatricial alopecia (CCCA) was not associated with any comorbid disorders, according to data from a retrospective cohort study published as a letter to the editor in the Journal of the American Academy of Dermatology.

Investigators conducted a retrospective chart review of adults with CCCA and demographically matched them with a control group of adults with nonscarring alopecia (NSA). They only included comorbidities which were present before CCCA diagnosis. A 2-tailed chi-squared test with Yates’ continuity correction was used to calculate P-values for comorbidities.

There were 153 patients with CCCA and 153 control patients included in the analysis. All participants lived in Southern US cities. No comorbidities were found to be significantly different between CCCA and NSA patients, including hypertension, obesity, peripheral artery disease, dyslipidemia, diabetes mellitus type 2, tobacco use, endocrine disorders, hidradenitis suppurativa, and HIV. More patients with CCCA than patients with NSA had a comorbid autoimmune disorder, but this was not statistically significant (22.9% vs 16.3%; P =.195). Hormonally driven diagnoses (uterine leiomyoma, endometrial hyperplasia, hirsutism) and psychiatric disorders were also more common in patients with CCCA than patients with CCCA, but this was not a statistically significant difference, either.

An important question is the temporality of comorbidities in relation to the onset of CCCA.

The study was limited by the difference in comorbidity screenings between patients with CCCA and control patients, possibly lowering the strength of the comparison.

Citing an earlier study which did find associations between CCCA and comorbidities, the study authors wrote that, “An important question is the temporality of comorbidities in relation to the onset of CCCA” as it not defined when the previous study captured the timing of CCCA comorbidities. They concluded that “additional studies with larger cohorts of CCCA patients are needed to provide a more accurate understanding of the comorbidities associated with the disease.”

Disclosure: A study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Jafari AJ, Brown C, Echuri H, Murina AT. Lack of association between comorbidities and central centrifugal cicatricial alopecia: a retrospective cohort study of 153 patients. J Am Acad Dermatol. Published online October 31, 2022. doi:10.1016/j.jaad.2022.09.056