Naked Hair Shafts as a Marker of Cicatricial Alopecia

December 2017 in “ American Journal of Dermatopathology ”

Kristina Doytcheva, Timothy L. Tan, Joan Guitart, Pedram Gerami, Pedram Yazdan

naked hair shafts cicatricial alopecia scalp biopsies inflammation fibrosis

Studysummary This study found that naked hair shafts significantly increased in cicatricial alopecias compared to non-cicatricial types, suggesting their potential use in diagnosing cicatricial alopecia. Our plain-language summary of this paper — not a Tressless recommendation.

In a 2017 study involving 622 scalp biopsies, researchers found that naked hair shafts (NHS) were present in 20% (69/345) of cicatricial alopecia cases and only 0.72% (2/277) of non-cicatricial alopecia cases, indicating a significant association of NHS with cicatricial alopecias (P < 0.0001). The frequency of NHS correlated with the severity of inflammation and fibrosis. While single NHS could appear in both types of alopecia, multiple NHS were more specific to cicatricial alopecia, suggesting their utility as a diagnostic marker, particularly in challenging cases. However, the presence of a single NHS should not lead to an immediate diagnosis of cicatricial alopecia but should encourage a thorough search for additional diagnostic features.

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