13. Follicular degeneration syndrome

 
Quotation from the 9th edition of Lever's:
 
"Controversy exists regarding the concept of FDS as a distinct entity. Headington did not consider it so, noting that premature desquamation of the inner root sheath, considered the pathognomonic histologic finding, was not specific for FDS and could be seen in chronic cutaneous lupus erythematosus and pseudopelade of Brocq. Others have also equated this disorder with pseudopelade of Brocq, or classified it under the rubric of central centrifugal scarring alopecia."
 
"Although the precise etiology is unknown, hair care practices that include heat, bleaching, pomades and traction, as well as the predominance in African Americans, suggest that environmental, cultural, and genetic factors, as well as possible structural factors unique to hair follicle in blacks, may play a role in the etiology of FDS."
 
Reference in the 9th edition to concepts contrary by A. Bernard Ackerman et al. (ABA): None.
 
Statements contrary by ABA:
 
"Error: Follicular degeneration syndrome is an authentic disease of the inner sheath. Reason: Follicular degeneration syndrome is wholly without authenticity; the vast majority of patients said to have that syndrome actually have traction alopecia and, moreover, no disease of the inner sheath, which proponents of the 'syndrome' claim to have degenerated, ever has been identified."
 
Ackerman AB, Böer A, Bennin B, Gottlieb GJ. Histologic Diagnosis of Inflammatory Skin Diseases, 3rd Edition. New York: Ardor Scribendi, 2005. (www.derm101.com)
 
Other works of ABA in which the ideas contrary are expressed:
 
1. Charissi C, Ackerman AB. Traction alopecia in African women and in descendants of them: a critique in historical perspective. Dermatopathology: Practical & Conceptual 9(4), 2003.
 
2. Ackerman AB, Mones J. Resolving Quandaries in Dermatology, Pathology and Dermatopathology. Vol 2 pp 171 New York: Ardor Scribendi, 2001.
 
3. Ackerman AB, Walton NW, Jones RE, Charissi C. Hot comb alopecia"/"follicular degeneration syndrome" in African-American women is traction alopecia! Dermatopathology: Practical & Conceptual 6(4):320-336, 2000.