Scalp Biopsy Influences Diagnostic Accuracy and Treatment in Black Women With Alopecia: A Retrospective Study

    February 2023 in “ Journal of The American Academy of Dermatology ”
    Annyella Douglas, Alison Romisher, Alexa Cohen, Romsin Zaya, Jonathan Wang, Jayson Suriano, Rachel Zachian, Neda Nikbakht
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    TLDR Scalp biopsies greatly improved diagnosis and treatment for Black women with unclear alopecia.
    The retrospective study examined the role of scalp biopsies in diagnosing and managing alopecia in Black women. The study involved 420 Black women over 18 years old diagnosed with alopecia from 2015 to 2020. The results showed that 34.5% of the patients were diagnosed with more than one type of alopecia, and 18.3% were not given a specific diagnosis. Only 9.5% of the patients underwent a biopsy, but it led to a change in diagnosis 70% of the time. The most common diagnosis after biopsy was central centrifugal cicatricial alopecia (27.5%). The study concluded that scalp biopsies were very helpful in identifying appropriate diagnoses and guiding management. It recommended offering scalp biopsies to Black women with alopecia when the diagnosis is not clear-cut.
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      Diffuse hair loss and scalp biopsies

      community Diffuse hair loss and scalp biopsies

      in Research  692 upvotes 3 months ago
      Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

      community I am a dermatologist with a clinical interest in alopecia. AMA

      in Will treatment work for me? 2 years ago
      In this conversation, 4990 discussed various treatments for hair loss, including oral minoxidil, PRP, transplan, Jak inhibitors, Dutasteride, Finasteride, Olumiant, Ketoconazole, RU58841, microneedling, baricitinib, and CCCA. They recommended scalp biopsies in unclear cases of DUPA, twice weekly to twice daily shampooing for topical minoxidil users, and two sessions spaced one month apart with follow up at month three to determine the effectiveness of PRP treatment.

      community How essential is scalp biopsy when dealing with hair loss?

      in Treatment  6 upvotes 4 weeks ago
      The user experienced hair loss despite using Fin and Min for 12 years and switched to Dutasteride, RU58841, and Keto scalp serum, but shedding and itch persist. They are considering increasing Dutasteride to 2.5mg and questioning the necessity of a scalp biopsy, with mixed opinions on its usefulness.

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