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TOPLINE: 

In a national study of US adults, the prevalence of primary lymphocytic cicatricial alopecias (PLCAs) was 37 per 100,000 persons and was higher among females, Black individuals, and metropolitan populations. 

METHODOLOGY:

• Researchers queried Epic Cosmos, a federated electronic health record network, for all US adults with two or more healthcare encounters between 2019 and 2024.
• PLCA cases were defined by ≥ 2 SNOMED CT diagnosis codes for l ichen planopilaris (LPP), central centrifugal cicatricial alopecia (CCCA), and frontal fibrosing alopecia (FFA).
• Researchers evaluated prevalence and annual incidence rates across sex, race, age categories, urbanicity, and US census region.

TAKEAWAY:

• Overall, 58,541 PLCA cases were reported with a 6-year prevalence for any PLCA of 37.1 per 100,000 persons. LPP was the most common subtype at 24.0 cases per 100,000 persons, followed by CCCA and FFA (10.0 and 9.8 cases, respectively, per 100,000 persons).
• The prevalence of all PLCA subtypes was substantially higher in females than in males (57.3 vs 12.5 per 100,000) and in Black vs White individuals (135.58 vs 22.86 per 100,000) and was twice as common in metropolitan vs rural areas (40.3 vs 20.1 per 100,000), with the highest prevalence in the Northeast.
• CCCA showed a 79:1 prevalence ratio between Black and White individuals. Among Black women aged 30-60 years, the prevalence of CCCA was 0.15%; overall, CCCA prevalence peaked at ages 41-50, and LPP and FFA peaked at ages 61-70.
• Annual incidence remained stable at 8.2-9.3 per 100,000 person-years from 2019 to 2024, with a slight decline in 2020 during the COVID-19 pandemic, likely due to diagnostic delays.

IN PRACTICE:

"This is the first nationwide prevalence study of scarring alopecia subtypes," the authors wrote. These findings, they added, "establish a national epidemiologic baseline for PLCAs and underscore the need for equitable access to timely diagnosis which can impact prognosis."

SOURCE:

The study was led by Alice Tang, BA, Icahn School of Medicine at Mount Sinai, New York, and was published online on May 12 in JAAD International.

LIMITATIONS:

The study limitations included potential misdiagnosis. Moreover, true prevalence could be underestimated in underserved populations, and regional differences could have been due to better access to dermatological care in metropolitan dermatology areas.

DISCLOSURES:

This study did not receive any specific funding. One author disclosed serving as a consultant and investigator for AbbVie, Arcutis Biotherapeutics, Attovia Therapeutics, LEO Pharma, Priovant Therapeutics, Sanofi, and several other pharmaceutical companies. Another author disclosed being an employee of Mount Sinai and receiving research funds and consulting fees from many drug companies, including Bristol Myers Squibb, Incyte, RAPT Therapeutics, Pfizer, and Sanofi. The other authors reported no financial disclosures.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.