Scarring Alopecia and Risk of Skin Cancer: A Literature Review.

Background: Primary scarring alopecia is characterized by irreversible hair follicle destruction and chronic inflammation, which may create a microenvironment conducive to skin cancer development. Non-melanoma skin cancers (NMSCs), such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), are influenced by factors like UV exposure and prolonged inflammation. The link between primary scarring alopecia and increased scalp skin cancer risk remains unclear.

Summary: This review analyzed thirteen studies reporting NMSC in primary scarring alopecia subtypes, including lichen planopilaris, discoid lupus erythematosus, folliculitis decalvans, and erosive pustular dermatosis of the scalp. Chronic inflammation, UV exposure, and immunosuppressive therapies were identified as potential contributors to malignancy.

Key messages: Primary scarring alopecia may increase susceptibility to SCC and BCC, particularly in areas of prolonged inflammation or immunosuppression. Clinicians should emphasize sun protection, routine follow-up, and patient education to minimize risk and improve outcomes. Further research is needed to clarify these associations.