Study Findings Increased Risk of Uterine Fibroids in American-American Women with Common Forms of Hair Loss

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In a study of medical records collected on hundreds of thousands of African women, Johns Hopkins researchers said they had evidence that women with the most common form of hair loss had more chance of developing uterine leiomyomas, or fibroids.

In a report in research, published in the Dec. 27 issue of JAMA Dermatology, researchers call on doctors treating women with central centrifugal cicatricial alopecia (CCCA) to identify patients who may be at greater risk of fibroids and should be screened for the condition , especially if they have symptoms such as severe bleeding and pain.

CCCA primarily affects black women and is the most common form of permanent alopecia in this population. The increased scar tissue that develops as a result of this unique hair loss may also explain the increased risk for uterine fibroids, which are characterized by fibrous growths in the uterine lining. Crystal Aguh, MD, assistant professor of dermatology at Johns Hopkins University School of Medicine, says that the paralysis associated with CCCA is similar to the movement associated with excess fibrous tissue in other areas of the body, a situation that can be explained if why women with such hair loss are at a higher risk for fibroids.

People of African descent, he said, are more likely to develop other abnormal inflammation, called fibroproliferative disorders, such as keloids (a type of raised scar after trauma), scleroderma. (an autoimmune disorder marked by thickening of the skin as well as internal organs), some varieties of lupus and clogged arteries.

Over the four-year period from 2013-2017, researchers analyzed patient data from the Johns Hopkins electronic medical record system (Epic) of 487,104 black women aged 18 and older. The prevalence of those with fibroids was compared in patients without CCCA.

Overall, the researchers found that 13.9 percent of women with CCCA also had a history of uterine fibroids compared to only 3.3 percent of black women without the condition. In total, out of 486,000 women reviewed, 16,212 had fibroids.

Within that population, 447 had CCCA, of which 62 had fibroids. The findings translated into a five-fold increased risk of uterine fibroids in women with CCCA, compared with age, sex and race equivalent controls.

Aguh cautioned that their study did not show any cause and effect relationship, or prove a common cause for the same condition. “The cause of the link between the two conditions remains unclear,” he said.

However, the association is strong enough, he added, to recommend that doctors and patients be informed.

Women with this type of alopecia damage should be screened not only for fibroids, but also for other diseases associated with excess fibrous tissue, according to Aguh.

It is estimated that 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 unlikely to be diagnosed, the some estimates report prevalence rates of up to 17 percent in black women with this condition.

The other authors of this paper are Ginette A. Okoye, MD by Johns Hopkins and Yemisi Dina of Meharry Medical College.

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