Follicular Swiss Cheese Pattern: Another Histopathologic Clue to Alopecia Areata

November 2010 in “ Journal of Cutaneous Pathology ”

Cornelia Müller, Laila El Shabrawi‐Caelen

alopecia areata dilated follicular infundibula peribulbar lymphoid infiltrate anagen catagen telogen hair follicles horizontal sections vertical sections AA hair loss lymphoid infiltrate hair growth phases

Studysummary This study reported that dilated follicular infundibula are a highly useful histopathologic criterion for diagnosing alopecia areata, particularly during its recovery stage.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

In a study of 56 biopsy specimens from 33 patients with alopecia areata (AA), it was found that 57% of the biopsies showed dilated follicular infundibula, which is a key feature for diagnosing AA and is particularly common in the recovery stage of the disease. This "follicular Swiss cheese" pattern helps distinguish AA from other hair loss conditions. Additionally, a peribulbar lymphoid infiltrate, another sign of AA, was present in only 38% of biopsies and more frequently observed in horizontal sections. The study also found that a shift from anagen to catagen/telogen hair follicles was a more consistent finding than the presence of peribulbar lymphocytes. The results suggest that dilated follicular infundibula and increased catagen/telogen follicles are significant indicators for diagnosing AA, and that both vertical and horizontal sections can be useful, but a careful clinicopathologic correlation is essential for accurate diagnosis.

View this study on onlinelibrary.wiley.com →

Discuss this study in the Community →

Research cited in this study

6 / 6 results

research Follicular Streamers (Stelae) in Scarring and Non-Scarring Alopecia

29 citations , July 2008 in “Journal of Cutaneous Pathology”

This study found that follicular streamers are mostly present in non-scarring alopecia cases, and tracking their location can improve diagnosis accuracy.

research Clinical Significance of Dermoscopy in Alopecia Areata: Analysis of 300 Cases

196 citations , June 2008 in “International Journal of Dermatology”

This study found that dermoscopic indicators like black dots and tapering hairs are valuable markers for diagnosing and assessing the severity and activity of alopecia areata in Asian patients.

research The Role of Scalp Dermoscopy in the Diagnosis of Alopecia Areata Incognita

150 citations , April 2008 in “Journal of The American Academy of Dermatology”

This study found that videodermoscopy reveals distinct dermoscopic features in patients with alopecia areata incognita, aiding in biopsy decisions by identifying the appropriate sampling area and potentially avoiding unnecessary procedures.

research Histopathologic Evaluation of Alopecias

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

This review outlines the classification, histopathologic presentation, and pathogenetic concepts of scarring and nonscarring alopecias, reporting no new clinical results and emphasizing the need for clinicopathologic correlation.

research The Histopathology of Noncicatricial Alopecia

43 citations , March 2006 in “Seminars in Cutaneous Medicine and Surgery”

This review examines the histopathologic features of four common types of noncicatricial alopecia and reports no new clinical results.

research Eosinophils in Fibrous Tracts and Near Hair Bulbs: A Helpful Diagnostic Feature of Alopecia Areata

64 citations , July 1997 in “Journal of The American Academy of Dermatology”

This study found that eosinophils are a useful diagnostic feature for alopecia areata, especially when the typical "swarm of bees" lymphoid infiltrate is absent, helping differentiate it from trichotillomania.