Androgenic Pattern Presentation of Scarring and Inflammatory Alopecia

    January 2010 in “ Journal of The European Academy of Dermatology and Venereology ”
    RM Rashid, Valencia D. Thomas
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    TLDR Many people diagnosed with androgenic alopecia might actually have hidden scarring or inflammation.
    The document reports on a study that examined the correlation between clinical and histological diagnoses of androgenic alopecia. A total of 31 tissue biopsies were collected, with 16 cases including scarring or inflammatory scalp disease in the differential diagnosis alongside androgenic alopecia. In these cases, 68% (11 cases) showed scar or inflammatory cell infiltrate upon biopsy. In the remaining 15 cases where scarring or inflammatory scalp disease was not included in the differential, 46% (7 cases) still showed scar or inflammatory cell infiltrate. The findings suggest that a significant number of cases diagnosed clinically as androgenic alopecia may actually involve occult inflammatory or scarring processes. This challenges the reliability of diagnosing androgenic alopecia based solely on clinical presentation and underscores the importance of considering a biopsy to confirm the diagnosis, especially since nearly half of the biopsied cases confirmed the clinical suspicion of an underlying scarring or inflammatory process.
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