Elastic Staining in Differentiating Between Follicular Streamers and Follicular Scars in Horizontal Scalp Biopsy Sections

    August 2017 in “ American Journal of Dermatopathology ”
    Timothy L. Tan, Joan Guitart, Pedram Gerami, Pedram Yazdan
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    TLDR EVG staining helps tell apart follicular scars from follicular streamers, aiding in diagnosing different types of hair loss.
    In the 2018 study, researchers investigated whether elastic Verhoeff-Van Gieson (EVG) staining could differentiate between follicular streamers and follicular scars in scalp biopsies, which is crucial for diagnosing different types of alopecia. The study included 64 cases of cicatricial alopecia and 53 cases of noncicatricial alopecia. The results indicated that EVG staining showed a loss and alteration of the elastic fiber network in follicular scars associated with cicatricial alopecia, while an intact elastic network was observed in follicular streamers associated with noncicatricial alopecia. The differences were statistically significant with P-values of <0.0001. The study concluded that EVG staining is a useful tool for distinguishing between these features, aiding in the diagnosis of cicatricial versus noncicatricial alopecias. However, the study noted limitations such as its retrospective nature and variability in biopsy procedures.
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