A large number of scalp disorders may destroy the hair follicles and result in cicatricial alopecia. These include diseases that primarily affect the hair follicles as well as diseases that affect the dermis and secondarily cause follicular destruction. Once established, cicatricial alopecia is a permanent condition that cannot be reversed by treatment. The differential diagnosis between the diseases that cause cicatricial alopecia requires a pathological examination. The site of biopsy is crucial for pathological diagnosis and can be better selected using dermoscopy. Current treatment options of primary cicatricial alopecia are limited as the precise mechanisms that trigger the diseases are still unknown.
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