Cicatricial Alopecia in Identical Twin Lumbee Native American Women

Central centrifugal cicatricial alopecia (CCCA) has become a well-known entity occurring mainly in African-American women, but is rarely encountered in other populations. This report describes a set of identical twin Lumbee Indian women, both developing cicatricial alopecia, with one sister diagnosed with CCCA overlap with lichen planopilaris and the other with CCCA. The Lumbee Tribe is a federally recognized group of Native Americans who reside in North Carolina. Lumbee Indians have shown an increased incidence of several metabolic and neurologic diseases but cicatricial alopecia has never been an identified associated disease of the Lumbee. Thus far, no published studies have shown cicatricial alopecia as occurring in identical twins or in Native Americans. This case report discusses the issues of haircare practices and genetics in contributing to cicatricial alopecia.