The reliability of horizontally sectioned scalp biopsies in the diagnosis of chronic diffuse telogen hair loss in women

    Rodney Sinclair, Damien Jolley, Rica Mallari, Jill Magee
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    TLDR Horizontally sectioned scalp biopsies are more reliable for diagnosing hair loss in women when three samples are taken instead of one.
    In a study from 2004, 207 women with chronic diffuse telogen hair loss were evaluated to determine the reliability of horizontally sectioned scalp biopsies in diagnosing female pattern hair loss (FPHL) and chronic telogen effluvium (CTE). The study concluded that a triple biopsy was more reliable than a single biopsy, with a diagnostic accuracy of 98% compared to 79%. The terminal to vellus-like hair ratio (T:V) used for diagnosis showed only moderate agreement and was not a definitive diagnostic tool. The study recommended that a triple biopsy should be performed for accurate diagnosis, especially in women with a mid-scalp clinical grade of 1 or 2, as it significantly improved diagnostic accuracy without increasing complexity or discomfort for the patient.
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