The Role of Hair Follicle Counts and Ratios in the Histopathological Assessment of Androgenic Alopecia, Alopecia Areata and Telogen Effluvium: Does Counting 'Count'?

March 2023 in “ Human Pathology ”

Eleni Ieremia, Catherine M. Stefanato

hair follicle counts ratios androgenetic alopecia alopecia areata telogen effluvium non-scarring alopecia histopathological assessment horizontal scalp biopsies follicular counts morphologic features AGA AA TE

TLDR Hair follicle counts and ratios are helpful in diagnosing hair loss types, but should be used with other specific features for accurate diagnosis.

The document discusses the role of hair follicle counts and ratios in diagnosing non-scarring alopecia, particularly androgenetic alopecia (AGA), alopecia areata (AA), and telogen effluvium (TE). The authors conducted a literature review of English language studies on the histopathological assessment of horizontal scalp biopsies for non-scarring alopecia. The results indicate that follicular counts and ratios are useful diagnostic tools, but they should be used in conjunction with the specific morphologic features of each alopecia subtype to make a confident diagnosis.

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Research cited in this study

14 / 14 results

research Follicular Density and Ratios in Scarring and Nonscarring Alopecia

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research An Atlas of Hair Pathology with Clinical Correlations

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research Histopathologic Features of Alopecia Areata Incognito: A Review of 46 Cases

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research Histopathology of Alopecia: A Clinicopathological Approach to Diagnosis

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research Hair Counts in Scalp Biopsy of Males and Females with Androgenetic Alopecia Compared with Normal Subjects

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

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research The Histopathology of Noncicatricial Alopecia

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research Hair Density in African Americans

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research Chronic Telogen Effluvium: Increased Scalp Hair Shedding in Middle-Aged Women

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Middle-aged women with chronic telogen effluvium experience increased hair shedding but usually don't get significantly thinner hair.

research Histopathology of Non-Scarring Alopecia

122 citations, April 1995 in “Journal of Cutaneous Pathology”

The document describes how to tell different types of non-scarring hair loss apart by looking at hair and scalp tissue under a microscope.

research Diagnostic and Predictive Value of Horizontal Sections of Scalp Biopsy Specimens in Male Pattern Androgenetic Alopecia

309 citations, May 1993 in “Journal of The American Academy of Dermatology”

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research Hair Anatomy for the Clinician

139 citations, July 1991 in “Journal of The American Academy of Dermatology”

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research The Transverse Anatomy of Androgenic Alopecia

42 citations, December 1990 in “The Journal of Dermatologic Surgery and Oncology”

The study found that horizontal sections of scalp biopsies are better for analyzing hair loss, showing fewer hairs and more fine hairs in balding areas.

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