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LTC Leonard C. Sperling, MC; CAPT Henry G. Skelton III, MC; COL Kathleen J. Smith, MC; COL Purnima Sau, MC; Kenneth Friedman, MD

Arch Dermatol. 1994;130(6):763-769.

Abstract
Background and Design
Follicular degeneration syndrome (FDS, formerly called hot comb alopecia) has only been described in black women. The clinical and histologic features of eight black men with a scarring alopecia resembling FDS were studied.

Observations
All eight men had evidence of scarring alopecia, which was most prominent on the crown of the scalp. None of the men were using chemical or physical modalities to straighten or style the hair. Overall, this group of men had more evidence of active inflammation than did the previously described women with FDS. The histologic features in the men were identical to those found in women with FDS. The presence of premature desqua- mation of the inner root sheath and migration of the hair shaft through the outer root sheath serve as histologic markers of FDS and separate it histologically from other forms of scarring alopecia.

Conclusions
Follicular degeneration syndrome is a common form of scarring alopecia in black men, just as it is in black women. In men, there is no association between chemical or mechanical hair styling techniques (eg, the ''hot comb'') and onset, progression, or severity of disease. The histologic features of FDS in men are identical to those in women.

(Arch Dermatol. 1994;130:763-769)

Author Affiliations
USA; USN; USA; USA

From the Dermatology Service, Walter Reed Army Medical Center (Drs Sperling and Sau), the Dermatopathology Branch, Armed Forces Institute of Pathology (Dr Skelton), the Walter Reed Army Institute of Research (Dr Smith), Washington, DC, and the Bethesda (Md) Dermatopathology Laboratory (Dr Friedman).

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