Reliability of Histopathology for the Early Recognition of Fibrosis in Traction Alopecia: Correlation with Clinical Severity

June 2019 in “ Dermatopathology ”

Reginald M Ngwanya, Henry Ademola Adeola, Renée A. Beach, Nomphelo Gantsho, Christopher L. Walker, Komala Pillay, Robert Prokopetz, Freedom Gumedze, Nonhlanhla P. Khumalo

traction alopecia fibrosis histopathology perifollicular fibrosis interfollicular fibrosis extruded hair shafts sebaceous glands

TLDR Histopathology is not reliable for detecting early fibrosis in traction alopecia or for showing how severe it is.

The study investigated the reliability of histopathological grading for detecting early fibrosis in traction alopecia (TA) and its correlation with clinical severity in 45 patients. It found that histopathology was unreliable for early fibrosis recognition in TA, as evidenced by poor agreement among dermatopathologists, with intraclass correlation coefficients of 0.55 for perifollicular fibrosis and 0.01 for interfollicular fibrosis, showing no correlation with clinical severity scores. Despite good agreement on the identification of extruded hair shafts and the presence of sebaceous glands, the study concluded that better diagnostic methods are needed due to the poor correlation between histopathological assessment and clinical grading of fibrosis in TA.

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