Histopathology of Alopecia: A Clinicopathological Approach to Diagnosis

    December 2009 in “ Histopathology
    Catherine M. Stefanato
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    TLDR The conclusion is that accurate diagnosis of different types of hair loss requires good teamwork between skin doctors and lab experts.
    The document reviewed the histopathological diagnosis of scarring and non-scarring alopecias, highlighting the importance of proper tissue sampling, laboratory processing, and clinical information. It detailed the histopathological features of various alopecias, including lymphocytic scarring alopecias like discoid lupus erythematosus and lichen planopilaris, neutrophilic scarring alopecias such as folliculitis decalvans, and non-scarring alopecias like androgenic alopecia, telogen effluvium, and alopecia areata. The document recommended a clinicopathological approach involving both transverse and vertical sectioning of biopsy specimens for improved diagnosis and outlined specific protocols for processing these biopsies. It also described the clinical presentations of these conditions, such as the pattern of hair loss in frontal fibrosing alopecia and central centrifugal cicatricial alopecia, and the histological distinctions between chronic telogen effluvium and female pattern hair loss, as well as the autoimmune nature of alopecia areata. The document emphasized the need for strong communication between dermatologists and pathologists for accurate diagnosis of alopecia.
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