Primary scalp alopecia: new histopathological tools, new concepts and a practical guide to diagnosis

Abstract

ReviewPrimary scalp alopecia: new histopathological tools, new concepts and a practical guide to diagnosisThe diagnosis of primary scalp alopecia remains one of the most challenging fields in dermatopathology. In this review, we would like to connect the established classification of primary alopecia into scarring (cicatricial) and non-scarring (non-cicatricial) with current concepts. We introduce a simplified pathway for the diagnosis of the most common causes of alopecia, including a discussion of tissue processing techniques and use of immunohistochemistry.Keywords: non-scarring (non-cicatricial ) alopecia, primary scalp alopecia, scarring (cicatricial) alopecia Kolivras A, Thompson C. Primary scalp alopecia: new histopathological tools, new concepts and a practical guide to diagnosis.

Utility of horizontal and vertical sections of scalp biopsies in various forms of primary alopecias

“…Recently, the new “Hovert technique”[ 18 ] is gaining popularity, wherein the scalp biopsy is transected approximately 1 mm below the epidermal surface to obtain an “epidermal disc.” This epidermal disc is subjected to vertical sectioning in conventional fashion, whereas the remaining lower portion of the biopsy is sliced for horizontal sections. Kolivras and Thompson[ 19 ] employed the Hovert technique and found the procedure to improve and simplify the diagnostics. However, more studies need to be conducted to affirm the efficiency and reproducibility of this newer method.…”

NonScarring Diffuse Hair Loss in Women: a Clinico‐Etiological Study from tertiary care center in North‐West India

“…The inherited forms are relatively rare, affect a younger age group, and result either from improper development or nondevelopment of follicles or due to a defective hair shaft. The acquired forms are more common, affect an older age group, and are broadly classified into diffuse, patterned, and focal hair loss, each further sub‐divided into scarring (cicatricial) and nonscarring (noncicatricial) forms …”

“…The acquired forms are more common, affect an older age group, and are broadly classified into diffuse, patterned, and focal hair loss, each further sub-divided into scarring (cicatricial) and nonscarring (noncicatricial) forms. 3,4,5 At birth approximately 5 million hair follicles are present, and no new hair follicles are added afterward. 6 During lifetime, each hair follicle undergoes continuous cycles of growth (anagen), resorption (catagen) and rest (telogen).…”

Correlation of clinical and pathologic evaluation of scarring alopecia

“…Distinguishing between scarring and nonscarring alopecia has important implications on diagnosis, treatment, and prognosis. Making this distinction has long been a challenge for dermatologists and dermatopathologists alike, and new classification schemata have been the subject of discussion in the literature …”

“…Making this distinction has long been a challenge for dermatologists and dermatopathologists alike, and new classification schemata have been the subject of discussion in the literature. 1,2 Classically, scarring alopecia involves an inflammatory process that destroys the hair follicle 3 and includes multiple disease entities. 4 Conversely, nonscarring alopecia occurs through a variety of mechanisms but does not destroy follicles.…”