Hair Transplantation in Primary Cicatricial Alopecias: A Review and Update

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This is a very important work about the controvertial topic of hair tranplantation in  ciocatricial alopecia. The work is well written, I just miss the diagnosis of fibrosing alopecia in a pattern distribution, which is frequently misdiagnosed by AGA. But this work is worth publishing due to the lack of information in the topic. This is an important work on the controversial topic of hair transplantation in cicatricial alopecia. The writing is strong; however, I noticed the absence of a diagnosis for fibrosing alopecia in a patterned distribution, which is often misdiagnosed as androgenetic alopecia (AGA). Despite this oversight, I believe the work is valuable and worthy of publication due to the limited information available on this topic.

Author Response

This is a very important work about the controvertial topic of hair tranplantation in  ciocatricial alopecia. The work is well written, I just miss the diagnosis of fibrosing alopecia in a pattern distribution, which is frequently misdiagnosed by AGA. But this work is worth publishing due to the lack of information in the topic. This is an important work on the controversial topic of hair transplantation in cicatricial alopecia. The writing is strong; however, I noticed the absence of a diagnosis for fibrosing alopecia in a patterned distribution, which is often misdiagnosed as androgenetic alopecia (AGA). Despite this oversight, I believe the work is valuable and worthy of publication due to the limited information available on this topic.

Thank you for your helpful feedback. We have rectified this omission and have searched the literature for reports of hair transplantation in fibrosing alopecia in a pattern distribution. While no original reports were found, we have discussed FAPD in the discussion of subtypes and an approach to this disease during transplantation.

Reviewer 2 Report

Comments and Suggestions for Authors

Thank you for submitting your review manuscript. After careful reading, it is found that the manuscript has certain academic value, but there are obvious deficiencies in formatting, which need to be revised and improved. The specific comments are as follows:​

1. Lack of Serial Numbers​（ Introduction ，2. Material & Methods，……）

It is recommended to use a standardized serial number system (e.g., 1., 1.1, 1.1.1, 2., 2.1, etc.) to sort the content of each chapter and section. This will not only enhance the readability of the manuscript but also help to show the logical connection between different parts of the content.

2. Tables Not in Three-line Table Format
3. There are also some minor issues with the citation of references.

For example，[11 14 15] should be [11, 14, 15]

4. The table (Table 1) is too long.
5. In Figure 1, A and B are not the same biological individual.
6. The conclusion should be a summary of the best part and further summarization is needed.

Author Response

Reviewer 2:

Thank you for submitting your review manuscript. After careful reading, it is found that the manuscript has certain academic value, but there are obvious deficiencies in formatting, which need to be revised and improved. The specific comments are as follows:​

1. Lack of Serial Numbers​（ Introduction ，2. Material & Methods，……）

It is recommended to use a standardized serial number system (e.g., 1., 1.1, 1.1.1, 2., 2.1, etc.) to sort the content of each chapter and section. This will not only enhance the readability of the manuscript but also help to show the logical connection between different parts of the content.

Thank you for this feedback. We have now organized our paper using a serial number system which we agree enhances the readability of the manuscript.

2. Tables Not in Three-line Table Format

Thank you for this feedback. We have re-formatted our tables so they are now in three-line table format.

3. There are also some minor issues with the citation of references. For example，[11 14 15] should be [11, 14, 15]

Thank you for this feedback. We have reviewed and corrected the citations.

4. The table (Table 1) is too long.

Thank you for the feedback. We agree and have moved it to the supplementary section. We have condensed the most pertinent points to make more streamlined tables (for table 1 and 2).

5. In Figure 1, A and B are not the same biological individual.

While these photos were obtained from our patient, it is not a representative image and therefore has been removed.

 6. The conclusion should be a summary of the best part and further summarization is needed.

Thank you for this feedback. We have revised the conclusion to highlight the most important takeaways from our paper.

Reviewer 3 Report

Comments and Suggestions for Authors

I find this review very useful, since treatment options of FFA and similar entities are very limited and outcomes significantly vary. Therefore, this review is of great importance for everyday practice and can help surgeons that perform hair transplantation more confidence in doing this procedure in FFA patients. However, at least one paragraph in discussion section should be dedicated to pathophysiology of this conditions and its interactions with procedure.

Author Response

Reviewer 3:

I find this review very useful, since treatment options of FFA and similar entities are very limited and outcomes significantly vary. Therefore, this review is of great importance for everyday practice and can help surgeons that perform hair transplantation more confidence in doing this procedure in FFA patients. However, at least one paragraph in discussion section should be dedicated to pathophysiology of this conditions and its interactions with procedure.

Thank you for this helpful feedback. We have revised the discussion to address how the pathophysiology of PCAs affect the efficacy of hair transplantation. This was an important addition to our paper.

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors The revised manuscript demonstrates notable enhancements in clinical applicability. I note that the revised manuscript has achieved notable improvements deserving recognition. The strategic use of serial numbers has significantly enhanced the text’s logical coherence, rendering its argumentative structure and content progression far more systematic and accessible to readers. Similarly, the streamlining of tables constitutes a praiseworthy revision: extraneous details have been effectively removed while critical data points are preserved, which substantially boosts the document’s readability and conciseness. That said, one minor yet notable issue requires correction: an erroneous serial number appears in the conclusion section. This inconsistency might obscure the structural clarity of the summary and hinder readers’ comprehension of key takeaways. It is therefore recommended that the author conduct a careful review of the serial numbering in the conclusion and make revisions as needed, to maintain the manuscript’s overall consistency and academic rigor. 1、VIII. Conclusion-----5. Conclusion
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Reviewer 3 Report

Comments and Suggestions for Authors

Manuscript is now improved with requested pathophysiological explanations and can be accepted for publication.