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Diagnostic usefulness of a peribulbar eosinophilic infiltrate in alopecia areata.
JAMA Dermatol. 2014 Sep; 150(9):952-6.JD

Abstract

IMPORTANCE

The histopathologic diagnosis of alopecia areata (AA) may be difficult in the chronic stage in which the presence of a peribulbar lymphocytic infiltrate is not definite. An eosinophilic infiltrate has been reported as a relatively common histopathologic finding and a helpful diagnostic feature in AA.

OBJECTIVE

To investigate the frequency and diagnostic usefulness of an eosinophilic infiltrate around the hair bulbs or within the fibrous tracts during the chronic stage of AA.

DESIGN, SETTING, AND PARTICIPANTS

A retrospective review was conducted at Chungbuk National University Hospital. A total of 162 scalp biopsy specimens of AA were analyzed.

MAIN OUTCOMES AND MEASURES

The frequency of a peribulbar eosinophilic infiltrate in AA.

RESULTS

In 30 of 162 specimens (18.5%) of AA in all stages, eosinophils were found around the hair bulbs with variable density but were not identified in the fibrous tracts of any specimen. Eosinophils around the hair bulbs were detected in 24 of 78 specimens (30.8%) of the acute stage of AA in which a peribulbar lymphocytic infiltrate was present, and eosinophils were densely infiltrated in 6 of these specimens (7.7%). In contrast, in the chronic stage of AA in which a peribulbar lymphocytic infiltrate was sparse or absent, eosinophils around the hair bulbs were found in only 6 of 84 specimens (7.1%); furthermore, eosinophils were sparsely present in all specimens. Pigmentary incontinence around the hair follicles was found in 58 of 84 specimens (69.0%), follicular miniaturization in 52 (61.9%), and shift to the catagen or telogen phase in 46 (54.8%).

CONCLUSIONS AND RELEVANCE

An eosinophilic infiltrate around the hair bulbs or within the fibrous tracts is not a common finding in the histopathologic characteristics of AA, especially in the chronic stage of the disease. Thus, the diagnostic usefulness of the eosinophilic infiltrate is limited to few cases of AA in the chronic stage. Other histopathologic findings, such as pigmentary incontinence around the hair follicles, follicular miniaturization, and shift to the catagen or telogen phase, are more useful diagnostic features in the cases of AA not showing a definite peribulbar lymphocytic infiltrate.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Yoon TY
Department of Dermatology, School of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Chungbuk, South Korea.
Lee DY
Department of Dermatology, School of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Chungbuk, South Korea.
Kim YJ
Department of Dermatology, School of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Chungbuk, South Korea.
Lee JY
Department of Dermatology, School of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Chungbuk, South Korea.
Kim MK
Department of Internal Medicine, School of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Chungbuk, South Korea.

MeSH

AdolescentAdultAgedAlopecia AreataChildChild, PreschoolEosinophilsFemaleHair FollicleHumansInfantMaleMiddle AgedRetrospective StudiesYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24990252

Citation

Yoon, Tae Young, et al. "Diagnostic Usefulness of a Peribulbar Eosinophilic Infiltrate in Alopecia Areata." JAMA Dermatology, vol. 150, no. 9, 2014, pp. 952-6.
Yoon TY, Lee DY, Kim YJ, et al. Diagnostic usefulness of a peribulbar eosinophilic infiltrate in alopecia areata. JAMA Dermatol. 2014;150(9):952-6.
Yoon, T. Y., Lee, D. Y., Kim, Y. J., Lee, J. Y., & Kim, M. K. (2014). Diagnostic usefulness of a peribulbar eosinophilic infiltrate in alopecia areata. JAMA Dermatology, 150(9), 952-6. https://doi.org/10.1001/jamadermatol.2014.62
Yoon TY, et al. Diagnostic Usefulness of a Peribulbar Eosinophilic Infiltrate in Alopecia Areata. JAMA Dermatol. 2014;150(9):952-6. PubMed PMID: 24990252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnostic usefulness of a peribulbar eosinophilic infiltrate in alopecia areata. AU - Yoon,Tae Young, AU - Lee,Dong Yoon, AU - Kim,Young Jin, AU - Lee,Ji Yeoun, AU - Kim,Mi Kyeong, PY - 2014/7/4/entrez PY - 2014/7/6/pubmed PY - 2015/1/3/medline SP - 952 EP - 6 JF - JAMA dermatology JO - JAMA Dermatol VL - 150 IS - 9 N2 - IMPORTANCE: The histopathologic diagnosis of alopecia areata (AA) may be difficult in the chronic stage in which the presence of a peribulbar lymphocytic infiltrate is not definite. An eosinophilic infiltrate has been reported as a relatively common histopathologic finding and a helpful diagnostic feature in AA. OBJECTIVE: To investigate the frequency and diagnostic usefulness of an eosinophilic infiltrate around the hair bulbs or within the fibrous tracts during the chronic stage of AA. DESIGN, SETTING, AND PARTICIPANTS: A retrospective review was conducted at Chungbuk National University Hospital. A total of 162 scalp biopsy specimens of AA were analyzed. MAIN OUTCOMES AND MEASURES: The frequency of a peribulbar eosinophilic infiltrate in AA. RESULTS: In 30 of 162 specimens (18.5%) of AA in all stages, eosinophils were found around the hair bulbs with variable density but were not identified in the fibrous tracts of any specimen. Eosinophils around the hair bulbs were detected in 24 of 78 specimens (30.8%) of the acute stage of AA in which a peribulbar lymphocytic infiltrate was present, and eosinophils were densely infiltrated in 6 of these specimens (7.7%). In contrast, in the chronic stage of AA in which a peribulbar lymphocytic infiltrate was sparse or absent, eosinophils around the hair bulbs were found in only 6 of 84 specimens (7.1%); furthermore, eosinophils were sparsely present in all specimens. Pigmentary incontinence around the hair follicles was found in 58 of 84 specimens (69.0%), follicular miniaturization in 52 (61.9%), and shift to the catagen or telogen phase in 46 (54.8%). CONCLUSIONS AND RELEVANCE: An eosinophilic infiltrate around the hair bulbs or within the fibrous tracts is not a common finding in the histopathologic characteristics of AA, especially in the chronic stage of the disease. Thus, the diagnostic usefulness of the eosinophilic infiltrate is limited to few cases of AA in the chronic stage. Other histopathologic findings, such as pigmentary incontinence around the hair follicles, follicular miniaturization, and shift to the catagen or telogen phase, are more useful diagnostic features in the cases of AA not showing a definite peribulbar lymphocytic infiltrate. SN - 2168-6084 UR - https://www.unboundmedicine.com/medline/citation/24990252/Diagnostic_usefulness_of_a_peribulbar_eosinophilic_infiltrate_in_alopecia_areata_ DB - PRIME DP - Unbound Medicine ER -