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Naked Hair Shafts as a Marker of Cicatricial Alopecia.
Am J Dermatopathol. 2018 Jul; 40(7):498-501.AJ

Abstract

Naked hair shafts (NHS) are free-floating hair shafts devoid of surrounding epithelium, supporting structures, and/or embedded in inflammation that may result from destruction of hair follicles by scarring processes such as inflammation and fibroplasia. Extensive examination of NHS has not been performed in scalp biopsies of alopecia. We retrospectively evaluated 622 scalp biopsies of alopecia [345 cicatricial alopecias (central centrifugal cicatricial alopecia, lichen planopilaris, discoid lupus erythematosus, acne keloidalis nuchae, and folliculitis decalvans] and 277 non-cicatricial alopecias [alopecia areata, androgenic alopecia, telogen effluvium, and psoriatic alopecia)] for the presence of NHS. NHS occurred in 0.72% (2/277) of non-cicatricial alopecias (1/102 of alopecia areata, 1/150 of androgenic alopecia, 0/17 of telogen effluvium, and 0/8 of psoriatic alopecia) and 20% (72/345) of cicatricial alopecias (27/118 of central centrifugal cicatricial alopecia, 29/109 of lichen planopilaris, 2/75 of discoid lupus erythematosus, 11/16 of acne keloidalis nuchae, and 3/27 of folliculitis decalvans). The presence of NHS was significantly increased in cicatricial alopecias in comparison with non-cicatricial alopecias; P value <0.0001. Among the cicatricial alopecias, 26% (92/345) had mild inflammation and/or fibrosis, of which 9% (9/92) had NHS. There were 73% (253/345) that had moderate to severe inflammation and/or fibrosis, of which 24% (63/253) had NHS, indicating that as the severity of inflammation and fibrosis increases, so does the presence of NHS. NHS rarely occurs in non-cicatricial alopecias. This variation may result from destruction of hair follicles by the inflammatory and scarring processes. The presence of NHS may be a useful adjunctive histopathologic feature in the diagnosis of cicatricial alopecia.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Doytcheva K
Departments of Dermatology, and.
Tan T
Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Guitart J
Departments of Dermatology, and. Robert H. Lurie Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Gerami P
Departments of Dermatology, and. Robert H. Lurie Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Yazdan P
Departments of Dermatology, and.

MeSH

AlopeciaHairHumansRetrospective Studies

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29293128

Citation

Doytcheva, Kristina, et al. "Naked Hair Shafts as a Marker of Cicatricial Alopecia." The American Journal of Dermatopathology, vol. 40, no. 7, 2018, pp. 498-501.
Doytcheva K, Tan T, Guitart J, et al. Naked Hair Shafts as a Marker of Cicatricial Alopecia. Am J Dermatopathol. 2018;40(7):498-501.
Doytcheva, K., Tan, T., Guitart, J., Gerami, P., & Yazdan, P. (2018). Naked Hair Shafts as a Marker of Cicatricial Alopecia. The American Journal of Dermatopathology, 40(7), 498-501. https://doi.org/10.1097/DAD.0000000000001075
Doytcheva K, et al. Naked Hair Shafts as a Marker of Cicatricial Alopecia. Am J Dermatopathol. 2018;40(7):498-501. PubMed PMID: 29293128.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Naked Hair Shafts as a Marker of Cicatricial Alopecia. AU - Doytcheva,Kristina, AU - Tan,Timothy, AU - Guitart,Joan, AU - Gerami,Pedram, AU - Yazdan,Pedram, PY - 2018/1/3/pubmed PY - 2018/10/16/medline PY - 2018/1/3/entrez SP - 498 EP - 501 JF - The American Journal of dermatopathology JO - Am J Dermatopathol VL - 40 IS - 7 N2 - Naked hair shafts (NHS) are free-floating hair shafts devoid of surrounding epithelium, supporting structures, and/or embedded in inflammation that may result from destruction of hair follicles by scarring processes such as inflammation and fibroplasia. Extensive examination of NHS has not been performed in scalp biopsies of alopecia. We retrospectively evaluated 622 scalp biopsies of alopecia [345 cicatricial alopecias (central centrifugal cicatricial alopecia, lichen planopilaris, discoid lupus erythematosus, acne keloidalis nuchae, and folliculitis decalvans] and 277 non-cicatricial alopecias [alopecia areata, androgenic alopecia, telogen effluvium, and psoriatic alopecia)] for the presence of NHS. NHS occurred in 0.72% (2/277) of non-cicatricial alopecias (1/102 of alopecia areata, 1/150 of androgenic alopecia, 0/17 of telogen effluvium, and 0/8 of psoriatic alopecia) and 20% (72/345) of cicatricial alopecias (27/118 of central centrifugal cicatricial alopecia, 29/109 of lichen planopilaris, 2/75 of discoid lupus erythematosus, 11/16 of acne keloidalis nuchae, and 3/27 of folliculitis decalvans). The presence of NHS was significantly increased in cicatricial alopecias in comparison with non-cicatricial alopecias; P value <0.0001. Among the cicatricial alopecias, 26% (92/345) had mild inflammation and/or fibrosis, of which 9% (9/92) had NHS. There were 73% (253/345) that had moderate to severe inflammation and/or fibrosis, of which 24% (63/253) had NHS, indicating that as the severity of inflammation and fibrosis increases, so does the presence of NHS. NHS rarely occurs in non-cicatricial alopecias. This variation may result from destruction of hair follicles by the inflammatory and scarring processes. The presence of NHS may be a useful adjunctive histopathologic feature in the diagnosis of cicatricial alopecia. SN - 1533-0311 UR - https://www.unboundmedicine.com/medline/citation/29293128/Naked_Hair_Shafts_as_a_Marker_of_Cicatricial_Alopecia_ DB - PRIME DP - Unbound Medicine ER -