No abstract

Three hundred and forty-seven tissue specimens were studied from 23 patients with male pattern alopecia. Characteristic features of pattern alopecia included: the presence of miniature or vellus follicles; a marked enlargement of the sebaceous glands and arrectores pilorum muscles; the presence of connective tissue streamers beneath the vellus follicles; and the thinning of the dermis. A mild perivascular infiltrate of mononuclear cells and mild capillary dilatation was sometimes seen. An increased number of mast cells was often a prominent feature. Histochemical procedures were performed for glycogen, acid mucosaccharides, inorganic substances, and enzymes including alkaline phosphatase, acid phosphatase, beta glucuronidase, cholinesterase, aminopeptidase, oxidases and dehydrogenases. Histochemical studies did not reveal any significantly abnormal enzyme changes other than the altered vascular and nerve supply to the the miniature follicles.

The lesions of adenoid squamous cell carcinoma develop in exposed areas, particularly about the head and neck regions in persons with fair skin who spend considerable time outside. The microsocopic features consist of invasion of the corium by proliferating atypical epithelial cells forming an adenoid pattern. The adenoid structure is usually composed of a single peripheral layer of cohesive cuboidal epithelial cells, and toward the center of the lobule there is acantholysis with formation of lumina containing dyskeratotic cells. The precursor stages of adenoid squamous cell carcinoma are classified histopathologically as senile keratosis with acantholysis. The most frequent histologic site of origin in this material was from the upper part of the pilary outer root sheath but some arose from the epidermis. Mucin associated with the adenoid structure showed identical histochemical reactions to those of mucin occurring in the pilary sheath and epidermis (hyaluronic acid) and differed from those of mucin seen in sweat glands (sialomucin). Among 155 patients having 213 lesions of adenoid squamous cell carcinoma there was metastasis in 3 patients (to regional lymph nodes in 2 and to regional lymph nodes and to lung in 1) and direct extension in 2 patients, which led to the death of the 5 patients. Surgical excision is the treatment of choice.