TLDR Dilated follicular infundibula and increased catagen/telogen follicles are key indicators for diagnosing alopecia areata.
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.
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July 2008 in “Journal of Cutaneous Pathology” Hair root sheaths are more common in non-scarring hair loss and help diagnose the type of hair loss.
