In a report of medical records gathered on thousands of African-American women, Johns Hopkins researchers say they will have evidence that women with a standard form of hair thinning have an increased potential for developing uterine leiomyomas, or fibroids.
In a report on the study, published in the December 27 problem of JAMA Dermatology, the researchers ask physicians who treat women with central centrifugal cicatricial alopecia (CCCA) to create patients aware they could be at increased risk for fibroids and really should be screened for the problem, particularly if they will have symptoms such as severe bleeding and pain.
CCCA predominantly affects black women and may be the most common type of permanent alopecia in this population. The surplus scar tissue formation that forms because of this type of hair thinning may also explain the bigger risk for uterine fibroids, which are seen as a fibrous growths in the liner of the womb. Crystal Aguh, M.D., assistant professor of dermatology at the Johns Hopkins University School of Medicine, says the scarring connected with CCCA is comparable to the scarring connected with excess fibrous tissue elsewhere in the torso, a situation that could explain why women with this particular type of hair thinning are at an increased risk for fibroids.
People of African descent, she notes, tend to be more susceptible to develop other disorders of abnormal scarring, termed fibroproliferative disorders, such as for example keloids (a kind of raised scar after trauma), scleroderma (an autoimmune disorder marked by thickening of your skin as well as organs), some forms of lupus and clogged arteries.
During a four-year period from 2013-2017, the researchers analyzed patient data from the Johns Hopkins electronic medical record system (Epic) of 487,104 black women ages 18 and over. The prevalence of these with fibroids was compared in patients with and without CCCA.
Overall, the researchers discovered that 13.9 percent of women with CCCA also had a brief history of uterine fibroids in comparison to only 3.3 percent of black women minus the condition. In absolute numbers, from the 486,000 women who have been reviewed, 16,212 had fibroids.
Within that population, 447 had CCCA, which 62 had fibroids. The findings translate to a fivefold increased threat of uterine fibroids in women with CCCA, in comparison to age, sex and race matched controls.
Aguh cautions that their study will not suggest any cause and effect relationship, or prove a standard cause for both conditions. “The reason for the link between your two conditions remains unclear,” she says.
However, she adds, to advise that physicians and patients be produced alert to it.
However, the association was strong enough, she adds, to recommend that physicians and patients be made aware of it.
Women with this type of scarring alopecia should be screened not only for fibroids, but also for other disorders associated with excess fibrous tissue, Aguh says.
An estimated 70 percent of white women and between 80 and 90 percent of African-American women will develop fibroids by age 50, according to the NIH, and while CCCA is likely underdiagnosed, some estimates report a prevalence of rates as high as 17 percent of black women having this condition.
The other authors on this paper were Ginette A. Okoye, M.D. of Johns Hopkins and Yemisi Dina of Meharry Medical College.
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