Pattern Hair Loss: Assessment of Microinflammation in Miniaturized and Terminal Hair Follicles Through Horizontal Histologic Sections

The document discusses the role of microinflammation in pattern hair loss (PHL), particularly in the context of hair follicle miniaturization. The authors previously evaluated microinflammation and apoptosis in 17 women with PHL and 5 female controls using horizontal sections and found no significant difference in inflammation between PHL patients and controls. However, microinflammation was more intense in miniaturized follicles compared to terminal ones (p=0.02) and was correlated with the follicle apoptosis index (rho=0.68). In a more recent study, they examined the pattern of microinflammation in skin biopsies from the frontal and occipital areas of 10 patients with female PHL. They found no difference in CD4+ or CD8+ lymphocyte infiltration between the areas, but CD4+ lymphocyte infiltration was more intense around miniaturized follicles in the frontal samples. The authors suggest that further studies with age- and gender-matched controls, preferably evaluated with horizontal sections comparing terminal and miniaturized follicles, are essential to understand the role of microinflammation in PHL.