The course of cicatricial alopecia is usually prolonged. Diagnosis and treatment of cicatricial alopecias is often challenging. They usually occur as retention cysts in cicatricial conditions of the conjunctiva. The cause of the various cicatricial alopecias is poorly understood. Among all, direct immunofluorescence is the gold standard for diagnosis of cicatricial pemphigoid. The majority of patients with cicatricial alopecia have no family history of a similar condition. Epidemiologic studies have not been performed to determine the incidence of cicatricial alopecias. Keratosis pilaris atropicans includes many forms of keratosis pilaris with cicatricial alopecia. Rare cases of COP have induced with lobar cicatricial atelectasis. Cicatricial alopecias are classified as primary or secondary. Complication of D- penicillamine therapy may trigger and causes cicatricial pemphigoid. Bullous Pemphigoid, Cicatricial Pemphigoid, Drug Eruptions. Nikolsky's sign is present in pemphigus and cicatricial pemphigoid, but not in bullous pemphigoid. Also in this category is cicatricial pattern hair loss (CPHL). The later structural changes of trachoma are referred to as "cicatricial trachoma".