Alopecia: Histologic Changes

    January 1989 in “ PubMed ”
    Bergfeld Wf
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    TLDR The review found that specific changes in scalp tissue can help diagnose different types of hair loss.
    The 1989 review "Alopecia: histologic changes" identified the major types of alopecia that can be diagnosed histologically as androgenic alopecia, alopecia areata, trichotillomania, inflammatory scarring alopecias, pseudopelade, and anagen and telogen effluviums. Common histologic features in chronic alopecias were found to include follicular plugging, decreased numbers of hair follicles, increased fibrous tracts, and superficial changes of actinic damage. Specific changes that aid in diagnosis include the presence of actinically damaged skin, the presence and site of dermal inflammation, a decrease in the numbers of hair follicles and a reversal of the anagen/telogen ratio, miniaturization of the hair follicle, evidence of involution, and the presence of scarring as demonstrated with elastic fiber stains. These histologic changes allowed for a reasonably specific diagnosis of alopecia.
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