Scarring Alopecia and Risk of Skin Cancer: A Literature Review

Area of Science:

• Dermatology
• Oncology

Background:

• Primary scarring alopecia involves irreversible hair follicle destruction and chronic inflammation.
• This inflammatory microenvironment may promote skin cancer development.
• The association between primary scarring alopecia and scalp skin cancer is not well understood.

Purpose of the Study:

• To review the existing literature on non-melanoma skin cancers (NMSCs) in patients with primary scarring alopecia.
• To identify risk factors and potential associations between specific subtypes of scarring alopecia and NMSC development.

Main Methods:

• A review of thirteen studies reporting NMSC in patients with primary scarring alopecia subtypes was conducted.
• Included subtypes were lichen planopilaris, discoid lupus erythematosus, folliculitis decalvans, and erosive pustular dermatosis of the scalp.

Main Results:

• Chronic inflammation, UV exposure, and immunosuppressive therapies were identified as potential contributing factors to NMSC development in these patients.
• Primary scarring alopecia may increase susceptibility to squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).

Conclusions:

• Patients with primary scarring alopecia may have an increased risk of developing SCC and BCC, especially in chronically inflamed or immunosuppressed areas.
• Emphasis on sun protection, regular follow-up, and patient education is crucial for risk mitigation and improved outcomes.
• Further research is necessary to elucidate the precise relationship between primary scarring alopecia and NMSC.