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Proteomic profiling on other primary cicatricial alopecias, such as frontal fibrosing alopecia and lichen planopilaris, have suggested a T helper 1–mediated inflammatory pathway, but in central centrifugal cicatricial alopecia (CCCA), the protein expression patterns are unknown. In this study, we sought to characterize protein expression patterns in CCCA to identify biomarkers of disease activity that will identify potential therapeutic avenues for treatment. Scalp protein quantification was performed to understand protein expression patterns in affected versus unaffected scalps in CCCA. A total of 5444 proteins were identified, of which 148 proteins were found to be differentially expressed in CCCA-affected scalp, with upregulation of adaptive immune pathways (IGHG3, P = .034; IGHG4, P = .01; IGG1, P = .026) and markers of fibrosis (ITGA1, P = .016; SFRP2, P = .045; TPM2, P = .029; SLMAP, P = .016) and downregulation of metabolic proteins (ALOX15B, P = .003; FADS2, P = .006; ELOVL5, P = .007; FA2H, P = .017; FAR2, P = .011; SC5D, P < .001). Our analysis revealed, to our knowledge, previously unknown humoral immune canonical pathways, notably IgG, implicated in CCCA and additionally confirmed aberrant lipid metabolism pathways implicated in diabetes mellitus, suggesting unique mechanisms of disease in patients with CCCA.

Climate change affects all aspects of ecosystems, including humans and numerous microorganisms. Fungi are especially sensitive to climate extremes. Persistently warmer temperatures at increasingly higher latitudes are contributing to ongoing expansion of the geographic ranges of known fungal pathogens. Alongside fungal species’ advancement into new territories, many have the capacity to develop thermotolerance. Consequently, a greater number of previously unharmful or underappreciated fungal species may emerge due to climate change.More frequent extreme weather events - including heat waves, drought, and flooding - also foster circumstances that favor the survival and infectivity of pathogens. We reviewed the English language literature in order to describe what is known about the effects of climate change on fungal infections with cutaneous manifestations. We included candidal infections, dermatophytoses, other mold infections, and deep fungal infections, and focused on organisms with evidence of climate sensitivity, particularly those that are emerging, spreading to new geographic regions, or both. This may provide an important tool for understanding the epidemiological patterns underlying fungal transmission, predicting future outbreaks, and adopting effective control strategies.