A Comparison of Vertical Versus Transverse Sections for the Histopathologic Diagnosis of Alopecias

    March 2009 in “ Journal of the American Academy of Dermatology ”
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    TLDR Transverse sections are better for non-scarring hair loss, vertical sections are better for lichen planopilaris, and either method works for other scarring hair loss types.
    The study aimed to compare the diagnostic value of vertical versus transverse sections in the histopathologic diagnosis of alopecias using punch biopsy specimens from 53 patients with hair loss. Transverse sections provided more accurate quantitative data of hair follicles and were found to be superior for diagnosing noncicatricial alopecias (P = .05). Vertical sections, however, were superior for diagnosing lichen planopilaris (P = .04). For other types of cicatricial alopecias, no statistical difference was found between the two methods (P > .05). The conclusion was that transverse sections should be preferred for non-cicatricial alopecias, vertical sections for lichen planopilaris, and either method for other cicatricial alopecias when only a single biopsy specimen is available.
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