Distinguishing Immunohistochemical Features of Alopecia Areata from Androgenic Alopecia

    Kambiz Kamyab, Mohammad Ebrahim Rezvani, Hasan Seirafi, Samira Mortazavi, Amir Teymourpour, Shahab Abtahi, Maryam Nasimi
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    TLDR Biopsy can differentiate between alopecia areata and androgenic alopecia, and if more information is needed, testing for CD3 and CD8 can help.
    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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