A Study of the Histopathological Features of Alopecias on Transverse Sections of Scalp Biopsies

January 2019 in “ Indian Journal of Dermatology ”

Mallika Goyal, Sujay Khandpur, M Ramam, Vinod Sharma, Manoj Kumar Singh

TLDR Transverse scalp biopsy sections help diagnose different alopecias by showing hair follicle details and inflammation patterns.

In 2019, researchers studied the histopathological features of various types of alopecia using transverse sections of scalp biopsies from 141 patients. The study found that transverse sections provided more information about the number and distribution of hair follicles, aiding in the diagnosis of different types of alopecia. Specific findings included miniaturization and shift toward telogen and catagen hair in androgenetic alopecia and alopecia areata, peribulbar inflammation in two-thirds of alopecia areata cases, and increased catagen hair and numerous pigment casts in trichotillomania. Inflammatory patterns varied between conditions, with lymphocytic infiltrate common in lichen planopilaris and discoid lupus erythematosus, and neutrophilic infiltrate seen in folliculitis decalvans. Despite the benefits of transverse sectioning, the study noted that overlapping features between different types of alopecia can complicate diagnosis.

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