P6.67 CICATRICIAL ALOPECIA IN AFRICAN AMERICAN WOMEN: CLINICAL EPIDEMIOLOGY AND QUALITY OF LIFE EVALUATION

Amy J. McMichael, David Peak, Ingrid Roseborough, and Tameka Lane

Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, U.S.A.

Objectives: In African American (AA) women, cicatricial alopecia is a severe problem with an increased prevalence and an undetermined psychosocial impact. In this preliminary study, we utilized a variant, the recently published NAHRS Cicatricial Alopecia Baseline Clinical Evaluation, to compare characteristics of AA women with cicatricial alopecia to AA women without alopecia to determine risk factors of scarring alopecia. Our secondary goal was to evaluate the quality of life in patients with scarring hair loss using accepted dermatology quality of life indices.

Methods: Clinical evaluation was conducted to determine eligibility to participate in the study.  A detailed form including past medical history and hair care practices was administered to both groups of patients.  For affected patients, the form also included hair loss severity and duration, associated symptoms, family history, treatment history, and a clinicopathological evaluation.

Three instruments were administered to each case patient.  The DLQI (Dermatology Life Quality Index) is a 10 item questionnaire that asks how much the skin problem has affected the subject’s life over the past week.  The HR-QoL (Health-related Quality of Life) instrument attempts to estimate the change in HR-QoL attributable to their disease.  Based on a 1 – 5 scale, it assesses eight domains in the presence and in the hypothetical absence of disease. The FNE (Fear of Negative Evaluation) is a 12 item questionnaire that assesses the perceived impressions of others by patients based on a 1 – 5 scale.  Data were entered into Microsoft Excel database and analyzed using SAS (Cary, NC).

Results: Our preliminary results show that history of keloids, candida infection, chemical relaxer usage, and natural style usage are more common in women with CA.  Affected patients may feel embarrassed about their condition, which does not affect their sexual life, and they believe that complete cure would significantly improve leisure and emotional aspects of their life.  These preliminary findings suggest that there are certain factors associated with cicatricial alopecia, which impacts the QOL of affected individuals

Conclusions: Scarring alopecia is an important quality of life issue for women of color.  Our data suggest that physicians, especially dermatologists, must not consider cicatricial alopecia a cosmetic concern, as it affects so many domains of quality of life.