I read with interest the recent article in the Archives by Kyei et al,1 which together with that of Olsen et al2 produced a rare harvest of comparable data on central centrifugal cicatricial alopecia (CCCA). Kyei et al state that our research group's South African studies “found a surprisingly low prevalence of CCCA (1.9%) in adults. ”1(p909) This prevalence included male participants3; it was 2.7% in the 604 women 18 years or older3 (and 0% in 574 school girls).4 Our studies predated the publication of the central scalp alopecia photographic scale.5 Using a grade of 3 or higher as a surrogate for CCCA, Olsen et al2 and Kyei et al1 reported a point prevalence of 5.6% and 17% in 529 and 310 women, respectively.
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