Alopecias: Practical Tips for the Management of Biopsies and Main Diagnostic Clues for General Pathologists and Dermatopathologists

    July 2023 in “ Journal of Clinical Medicine
    Fernando Pinedo Moraleda, Belén Tristán-Martín, Giulia Greta Dradi
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    TLDR The document concludes that understanding hair follicle histology and the hair cycle is crucial for diagnosing alopecia.
    The document provides a detailed overview of diagnosing various types of alopecia, emphasizing the importance of understanding hair follicle histology and the follicular cycle. It highlights the need for effective collaboration between dermatologists and pathologists, and the ideal biopsy should consist of two punch biopsies, each measuring 0.4 cm and taken obliquely. Alopecia is classified into nonscarring and scarring types, with distinct clinical presentations and histological features. For example, androgenetic alopecia results from hormonal and genetic factors leading to hair follicle miniaturization, while telogen effluvium is characterized by a sudden transition of hair follicles from the growth phase to the resting phase. The document also reviews various primary scarring alopecias, including those associated with lymphocytic infiltrate like lupus erythematosus and lichen planopilaris. It concludes by emphasizing the importance of understanding the histopathology of the hair follicle and hair cycle in diagnosing alopecia.
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