Distinguishing Immunohistochemical Features of Alopecia Areata from Androgenic Alopecia

May 2018 in “ Journal of Cosmetic Dermatology ”

Kambiz Kamyab, Mohammad Ebrahim Rezvani, Hasan Seirafi, Samira Mortazavi, Amir Teymourpour, Shahab Abtahi, Maryam Nasimi

alopecia areata androgenic alopecia CD3 CD8 immunohistochemical features inflammation density biopsy T cells intrafollicular AA AGA

Studysummary This study reported that the most reliable way to differentiate alopecia areata from androgenic alopecia is by detecting intrafollicular CD3 and CD8 cell density, with CD3 being the most specific and sensitive marker. Our plain-language summary of this paper — not a Tressless recommendation.

In 2019, a study involving 60 patients (30 with alopecia areata (AA) and 30 with androgenic alopecia (AGA)) was conducted to differentiate between AA and AGA based on immunohistochemical features. The researchers found that the inflammation density for AA was significantly higher than AGA in CD3 and CD8, while CD4 and CD20 were not helpful in differentiation. The most specific and sensitive test for differentiating AA from AGA was found to be CD3, especially when the density of CD3 and CD8 T cells were significant in more than 50% of the infiltrated cells and were located intrafollicularly. The study concluded that in controversial cases, biopsy provides sufficient information for differentiation, and if these criteria are not enough, immunohistochemical examination by CD3 and CD8 could be helpful.

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