Cicatricial Alopecia: Classification and Histopathology

July 2008 in “ Dermatologic therapy ”

Najwa Somani, Wilma F. Bergfeld

cicatricial alopecia folliculocentric inflammation hair follicles irreversible hair loss lymphocytic neutrophilic mixed histopathology special stains direct immunofluorescence

TLDR Early detection and histopathology are crucial to prevent permanent hair loss in cicatricial alopecia.

Primary cicatricial alopecias were a complex group of disorders marked by folliculocentric inflammation leading to the destruction of hair follicles and irreversible hair loss. They were classified based on the predominant cell type present: lymphocytic, neutrophilic, or mixed. Histopathology played a crucial role in diagnosis, with early detection being essential to prevent permanent hair loss. The review highlighted key histopathologic findings and additional diagnostic clues from special stains and direct immunofluorescence studies. Despite thorough evaluation, accurate diagnosis could be challenging due to overlapping features among the disorders, emphasizing the importance of correlating histology with clinical presentation.

View this study on onlinelibrary.wiley.com →

Discuss this study in the Community →

Research cited in this study

16 / 16 results

research Histopathologic Evaluation of Alopecias

90 citations, June 2006 in “The American Journal of Dermatopathology”

The document concludes that accurate diagnosis of different types of hair loss requires careful examination of hair and scalp tissue, considering both clinical and microscopic features.

research A Comparison of Vertical Versus Transverse Sections in the Evaluation of Alopecia Biopsy Specimens

56 citations, July 2005 in “Journal of The American Academy of Dermatology”

Using both vertical and transverse sections gives a better diagnosis of alopecia than using one method alone.

research Primary Cicatricial Alopecias: Clinicopathology of 112 Cases

254 citations, December 2003 in “Journal of the American Academy of Dermatology”

Accurate diagnosis and aggressive treatment are crucial to prevent permanent hair loss in cicatricial alopecia.

research Cicatricial (Scarring) Alopecia: Clinical Presentations, Etiologies, and Histopathologic Features

13 citations, April 2001 in “International Journal of Dermatology”

Different types of scarring alopecia may be stages of one disease, and accurate diagnosis is crucial to prevent permanent hair loss.

research Lymphocytic Mediated Alopecia: Histological Classification by Pattern Analysis

29 citations, March 2001 in “Clinics in Dermatology”

Steven Kossard classified lymphocyte-related hair loss into four patterns, each linked to different types of baldness.

research Elastic Tissue in Scars and Alopecia

80 citations, March 2000 in “Journal of cutaneous pathology”

The VVG stain effectively differentiates scar tissue from normal skin and helps classify types of permanent alopecia.

research Acquired Scalp Alopecia: A Review

37 citations, May 1999 in “Australasian Journal of Dermatology”

Early diagnosis and treatment are crucial for preventing permanent hair loss in various scalp conditions, and while new treatments are promising, more research is needed to evaluate their effectiveness.

research Vertical and Transverse Sections of Alopecia Biopsy Specimens: Combining the Two to Maximize Diagnostic Yield

71 citations, March 1995 in “Journal of The American Academy of Dermatology”

Using both vertical and transverse sections for alopecia biopsies improves diagnosis without extra cost.

research Clinical Findings, Cutaneous Pathology, and Response to Therapy in 21 Patients With Keratosis Pilaris Atrophicans

78 citations, April 1994 in “Archives of dermatology”

The study found that Keratosis Pilaris Atrophicans is a genetic skin condition that starts in childhood, involves inflammation and scarring, and current treatments are only somewhat effective.

research Keratosis Follicularis Spinulosa Decalvans: A Family Study of Seven Male Cases and Six Female Carriers

41 citations, January 1992 in “Journal of medical genetics”

The study found that males with KFSD had severe skin and eye symptoms, while female carriers had milder symptoms.

research Acne Keloidalis: A Review

78 citations, June 1989 in “The Journal of dermatologic surgery and oncology”

Acne keloidalis is a chronic skin condition on the back of the neck in young black men, needing surgery for severe cases.

research Ichthyosis Follicularis With Alopecia and Photophobia

75 citations, September 1985 in “Archives of dermatology”

Two boys had a rare skin condition needing to be differentiated from similar disorders, with unclear inheritance due to few cases.

research Keratosis Follicularis Spinulosa Decalvans

54 citations, January 1983 in “Archives of Dermatology”

KFSD is a rare condition causing scarring hair loss, with no effective treatment known at the time of the report.

research Immunofluorescent Findings and Clinical Overlap in Two Cases of Follicular Lichen Planus

32 citations, August 1982 in “Journal of the American Academy of Dermatology”

GLPLS and LPP are variants of lichen planus.

research Alopecia

22 citations, June 1980 in “International Journal of Dermatology”

The document concludes that correct diagnosis of alopecia types is crucial, scalp biopsies are important, and more research is needed.

research Erosive Pustular Dermatosis of the Scalp

187 citations, May 1979 in “British Journal of Dermatology”

Topical steroids can manage chronic scalp pustules in elderly women.

Related Community Posts Join

6 / 13 results

community I am a dermatologist with a clinical interest in alopecia. AMA

in Will treatment work for me? 2 years ago

In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

community Diffuse hair loss and scalp biopsies

in Research 692 upvotes 3 months ago

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

community Finasteride not working isnt it MPB?

in Finasteride/Dutasteride 5 upvotes 6 months ago

A user is concerned that finasteride isn't working for their hair loss, questioning if it's due to male pattern baldness or low iron levels. They are advised to take finasteride daily and get blood work done.

community Finasteride doesn't work for me in 2 years and my bloodtest result just came in.

in Progress Pictures 88 upvotes 1 year ago

A user has been treating hair loss with finasteride for two years without success and is experiencing an itchy scalp with seborrhea. Despite low DHT levels, they are still losing hair, suggesting that DHT might not be the main cause of their hair loss, and they are considering other treatments or causes.

community Wanted to say that Derma rolling and Pumpkin seed oil helped my crown out.

in Treatment 4 upvotes 5 years ago

Derma rolling, pumpkin seed oil, and daily massages helped regrow weak hairs on the crown. Nizoral shampoo and yoga also contributed to reducing scalp pain and stress.

community DHT is about to get smashed ….

in Update 802 upvotes 2 months ago

The conversation discusses hair loss treatments like topical finasteride with minoxidil, oral dutasteride, and essential oils. Oral treatments like dutasteride and finasteride are seen as more effective, though some prefer topicals to avoid side effects.

Related Research

2 / 2 results

research Evidence-Based Clinical Guidelines for Treatment: Acne and Androgenetic Alopecia

1 citations, March 2012 in “Journal of Dermatology and Cosmetic”

research Cicatricial Alopecia: Classification and Histopathology

74 citations, July 2008 in “Dermatologic therapy”

Early detection and histopathology are crucial to prevent permanent hair loss in cicatricial alopecia.