Dealing With Loss: Simplified Diagnostic Approach for Alopecia

March 2011 in “ Journal of Cutaneous Pathology ”

Timothy H. McCalmont

alopecia cicatricial alopecia non-scarring alopecia lymphocyte-mediated neutrophil-mediated lupus erythematosus lichen planus transverse sectioning biopsy analysis Ho-Vert technique

TLDR The document suggests simplifying alopecia diagnosis and improving techniques for better accuracy.

The document from March 28, 2011, addresses the difficulties in diagnosing and classifying alopecia, especially cicatricial alopecia, due to its complexity and the ambiguity in distinguishing between types. It proposes a simplified diagnostic approach by categorizing non-scarring alopecia into a few types and cicatricial alopecia into lymphocyte-mediated and neutrophil-mediated subtypes. The author questions the common association of lupus erythematosus and lichen planus in diagnoses and highlights the usefulness of transverse sectioning in biopsy analysis, as well as the potential of the Ho-Vert technique to improve diagnostic accuracy. The document emphasizes the need for more research and improved diagnostic techniques in the field of alopecia.

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Research cited in this study

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research Cytokeratin 15 Expression in Central, Centrifugal, Cicatricial Alopecia: New Observations in Normal and Diseased Hair Follicles

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research The HoVert Technique: A Novel Method for the Sectioning of Alopecia Biopsies

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research Follicular Swiss Cheese Pattern: Another Histopathologic Clue to Alopecia Areata

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Dilated follicular infundibula and increased catagen/telogen follicles are key indicators for diagnosing alopecia areata.

research Histopathology of Alopecia: A Clinicopathological Approach to Diagnosis

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The conclusion is that accurate diagnosis of different types of hair loss requires good teamwork between skin doctors and lab experts.

research Vertical vs. Transverse Sections in Alopecia Biopsy Diagnosis

33 citations, August 2005 in “The American Journal of Dermatopathology”

Both vertical and transverse sections are useful for diagnosing alopecia, but using both methods together is best.

research A Comparison of Vertical Versus Transverse Sections in the Evaluation of Alopecia Biopsy Specimens

56 citations, July 2005 in “Journal of The American Academy of Dermatology”

Using both vertical and transverse sections gives a better diagnosis of alopecia than using one method alone.

research Postmenopausal Frontal Fibrosing Alopecia: A Frontal Variant of Lichen Planopilaris

329 citations, January 1997 in “Journal of the American Academy of Dermatology”

Frontal fibrosing alopecia is a hair loss condition in postmenopausal women, similar to lichen planopilaris, with ineffective treatments.

research Vertical and Transverse Sections of Alopecia Biopsy Specimens: Combining the Two to Maximize Diagnostic Yield

71 citations, March 1995 in “Journal of The American Academy of Dermatology”

Using both vertical and transverse sections for alopecia biopsies improves diagnosis without extra cost.

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