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- Title
Utility of Horizontal Sections of Scalp Biopsies in Differentiating between Androgenetic Alopecia and Alopecia Areata.
- Authors
Yadav, Deepika; Khandpur, Sujay; Ramam, M.; Singh, Manoj K.; Sharma, Vinod K.; Singh, Manoj K; Sharma, Vinod K
- Abstract
<bold>Background: </bold>Androgenetic alopecia (AGA) and alopecia areata (AA) are common causes of alopecia which can sometimes be difficult to differentiate clinically. Horizontal sections of scalp biopsies are used to study non-cicatricial alopecias due to the ability to perform both quantitative and morphometric analysis of hair follicles on them.<bold>Methods: </bold>It was a prospective, cross-sectional study conducted to assess the utility of horizontal sections to differentiate between the alopecias. Fifty-two cases were included: 20 cases of male AGA, 11 of female AGA and 21 cases of AA. After clinical examination and dermoscopy, a skin biopsy was taken and subjected to transverse sectioning. Histopathological assessment was done by two dermatopathologists blinded to clinical details.<bold>Results: </bold>Among the quantitative parameters, terminal:vellus hair ratio (3.08 in AGA and 1.83 in AA, p = 0.0091) and anagen:non-anagen hair ratio (9.25 in AGA and 3.56 in AA, p = 0.0021) were significantly lower in AA. In qualitative parameters, peribulbar inflammation was seen in 63% of AA cases (p = 0.0001). Pigment casts were seen in twice the number of AA (57%) than AGA (26%) cases. Broad avascular stelae and focal trichomalacia were seen in 9.5% of AA cases.<bold>Conclusion: </bold>Besides peribulbar inflammation, we found a lower anagen:non-anagen hair ratio and presence of pigment casts in transverse sections of scalp biopsies favouring AA over AGA.
- Subjects
BALDNESS; ALOPECIA areata; BIOPSY; DERMATOLOGISTS; INFLAMMATION; HAIR follicles; LONGITUDINAL method; SCALP; CROSS-sectional method
- Publication
Dermatology (10188665), 2018, Vol 234, Issue 3/4, p137
- ISSN
1018-8665
- Publication type
journal article
- DOI
10.1159/000490459