The Role of the Scalp Biopsy in the Evaluation of Alopecia

    August 2023 in “ Journal of the American Academy of Dermatology ”
    Leonard C. Sperling
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    TLDR A scalp biopsy is essential for accurately identifying different types of hair loss.
    A scalp biopsy is crucial in accurately diagnosing alopecia, according to the document. The standard procedure involves a 4-mm punch biopsy extending into the fat, sectioned horizontally at multiple levels. The biopsy site selection, which depends on the type of alopecia, can significantly influence the diagnosis. The document also emphasizes the importance of the clinician's information provided to the pathologist, including the precise biopsy site and a clinical differential diagnosis. The wording in the biopsy report can indicate the level of diagnostic certainty, with phrases like “changes diagnostic of…” or “typical of…” indicating high certainty, while “consistent with” or “compatible with” suggest probable validity, and “suggestive of…” indicating low certainty. The document also notes that if the initial biopsy site selection is incorrect, an additional biopsy may be needed.
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      community My scalp punch biopsy results🤔?

      in Female  8 upvotes 1 year ago
      Female using Rogaine foam for hair loss had scalp punch biopsy, diagnosed with Androgenetic Alopecia (AGA). Doctor recommended starting Spironolactone 50mg.
      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 Nothing's working, I feel depressed, also hopeless for the first time

      in Update  102 upvotes 2 years ago
      A user's experience with hair loss treatments, including Finasteride, Minoxidil, Nizoral Shampoo, Rosemary Oil, Vitamin D, Biotin, Vitamin C, Zinc and Dermarolling, that have not been successful over the past 14 months. Other users gave advice on how to cope with the issue, such as exercising, changing mindset, and shaving their head.

      community Huge holes on donor area of scalp is this even normal?

      in Transplants  106 upvotes 11 months ago
      The conversation is about a person experiencing significant hair loss in the donor area after a hair transplant, with others suggesting it might be shock loss. The person is taking oral minoxidil and dutasteride to help with the issue.

      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.

      community Lost density 60% all over scalp in 120 days (4months)

      in Update  10 upvotes 5 months ago
      A user lost 60% hair density in 4 months, started finasteride and microneedling, and has greasy, flaky, yellowish scalp. They are awaiting biopsy results, and another user suggested trying ketoconazole shampoo.

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