A Detective Look at Hair Biopsies from African-American Patients

The retrospective study by Miteva and Tosti reviewed 60 scalp biopsies from African-American patients, including 25 cases of central centrifugal cicatricial alopecia (CCCA), 22 cases of traction alopecia (TA), and other conditions. The study identified specific morphological features of African-American hair and scalp, such as a golf club-shaped bulb, elliptical hair shaft, and paired grouping of hair follicles, which contribute to the hair's mechanical weakness and susceptibility to damage. For CCCA, characteristic clues included premature desquamation of the inner root sheath and the "goggles" sign, while TA was indicated by preserved sebaceous glands and follicular miniaturization. The study concluded that recognizing these features could aid dermatopathologists in diagnosing hair loss conditions in African-American patients, even with only vertical biopsy sections, and enhance understanding of the morphological basis for hair damage in this population.