Giant Cells in Male Pattern Alopecia: A Histologic Marker and Pathogenetic Clue

In 1979, a study involving 65 biopsy specimens from patients with male pattern alopecia revealed that 21 specimens (32%) had multinucleate giant cells in the dermis, a feature not found in other types of alopecia. These giant cells were often near hair shaft fragments and could serve as a diagnostic marker for male pattern alopecia, especially in advanced stages. Additionally, the study compared these findings with 116 scalp biopsies from various alopecia types and confirmed the uniqueness of the giant cells to male pattern alopecia. The study suggested that the shrinking of hair follicles and the subsequent structural loss might cause hair to be perceived as a foreign body, leading to the giant cell reaction, although the exact pathogenesis of male pattern alopecia was still not fully understood.