Funding sources This work was supported in part by the North American Hair Research Society. G.Y. is supported by NIAMS grant RO1AR55902-4.
Central centrifugal cicatricial alopecia severity is associated with cowhage-induced itch
Article first published online: 30 JAN 2013
© 2012 The Authors. BJD © 2012 British Association of Dermatologists
British Journal of Dermatology
Volume 168, Issue 2, pages 253–256, February 2013
How to Cite
Bin Saif, G.A., McMichael, A., Kwatra, S.G., Chan, Y.-H. and Yosipovitch, G. (2013), Central centrifugal cicatricial alopecia severity is associated with cowhage-induced itch. British Journal of Dermatology, 168: 253–256. doi: 10.1111/bjd.12043
Conflicts of interest None declared.
- Issue published online: 30 JAN 2013
- Article first published online: 30 JAN 2013
- Accepted manuscript online: 17 SEP 2012 10:20AM EST
- Accepted for publication 5 September 2012
Background Patients with central centrifugal cicatricial alopecia (CCCA) often suffer from varying degrees of itch, pain and burning sensations. However, the neural component of these skin sensations has not been assessed.
Objective To conduct a comprehensive analysis of C nerve fibre function relating to itch and pain perception in patients with CCCA using thermosensory testing and experimental itch models.
Methods Fifteen healthy African-American women and 16 African-American female patients with CCCA participated in the study and underwent quantitative computerized thermosensory testing to assess warmth and heat pain thresholds. Itch was induced using histamine iontophoresis and application of cowhage spicules, and the intensity of each itch was assessed. The association between itch intensity and CCCA severity score was examined.
Results A positive correlation between CCCA severity score and peak itch ratings of cowhage on the lesional scalp (crown) was observed (P = 0·023, r = 0·562). Notably, the histamine peak itch rating was not found to have a significant correlation with CCCA severity score (P = 0·913). The crown also had significantly higher warmth and pain thresholds than the occiput in both healthy subjects and patients with CCCA.
Conclusions Our results suggest a putative role for the protease-activated receptor (PAR)-2, which is activated by cowhage, in the pathogenesis of CCCA. Future studies should examine PAR-2-directed therapeutics for patients with CCCA. Examining for itch and other dysaesthesias in patients with CCCA is of vital importance to dermatologists in assessing disease severity.