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Distinguishing immunohistochemical features of alopecia areata from androgenic alopecia.
J Cosmet Dermatol. 2019 Feb; 18(1):422-426.JC

Abstract

BACKGROUND

Distinction between alopecia areata (AA) and androgenic alopecia (AGA) can be made according to clinical presentation and biopsy findings. However, it is sometimes difficult to differentiate them, especially when the diffuse pattern of both AA and AGA is in the differential diagnosis of hair loss in androgen-dependent areas.

OBJECTIVES

To evaluate the characteristics of inflammatory cell infiltration using CD3, CD4, CD8, and CD20 antigens, in AA and AGA to find some consistent histological clues for distinguishing these two entities.

METHODS

A retrospective analysis of patients with diagnosed AA (30 cases) and AGA (30 cases) was performed based on the clinical and histopathological criteria. We studied immunohistochemical findings for CD3, CD4, CD8, and CD20 in all selected cases.

RESULTS

Immunohistochemical stains for CD4 and CD20 were not helpful in differentiating AA from AGA, but the inflammation density for AA was significantly (P-value = .025, .001) higher than AGA in CD3 (specificity= 86.7% and sensitivity= 96.7%) and CD8 (specificity= 50% and sensitivity=86.6%). Our findings revealed that intrafollicular CD3 (P-value = .017) and CD8 (P-value = ˂.001) infiltrations were significantly higher in AA samples in comparison with AGA.

CONCLUSION

Characterization of CD3 and CD8 in IHC samples is helpful, especially when the density of CD3 and CD8 T cells are significant in more than 50% of the infiltrated cells and are located intrafolliculary. Moreover, the most specific and sensitive test for differentiating of AA from AGA is CD3.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Kamyab K
Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Rezvani M
Student of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Seirafi H
Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Mortazavi S
Fellowship of Dermatopathology, Pathology Department, Tehran University of Medical Sciences, Tehran, Iran.
Teymourpour A
Student of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Abtahi S
Care and Public Health Research Institute (CAPHRI), Maastricht, The Netherlands.
Nasimi M
Autoimmune Bullous Disease Research Center, Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.

MeSH

AdolescentAdultAgedAlopeciaAlopecia AreataAntigens, CD20Antigens, DifferentiationCD3 ComplexCD4 AntigensCD8 AntigensChildCross-Sectional StudiesFemaleHair FollicleHumansImmunohistochemistryMaleMiddle AgedRetrospective StudiesYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29790258

Citation

Kamyab, Kambiz, et al. "Distinguishing Immunohistochemical Features of Alopecia Areata From Androgenic Alopecia." Journal of Cosmetic Dermatology, vol. 18, no. 1, 2019, pp. 422-426.
Kamyab K, Rezvani M, Seirafi H, et al. Distinguishing immunohistochemical features of alopecia areata from androgenic alopecia. J Cosmet Dermatol. 2019;18(1):422-426.
Kamyab, K., Rezvani, M., Seirafi, H., Mortazavi, S., Teymourpour, A., Abtahi, S., & Nasimi, M. (2019). Distinguishing immunohistochemical features of alopecia areata from androgenic alopecia. Journal of Cosmetic Dermatology, 18(1), 422-426. https://doi.org/10.1111/jocd.12677
Kamyab K, et al. Distinguishing Immunohistochemical Features of Alopecia Areata From Androgenic Alopecia. J Cosmet Dermatol. 2019;18(1):422-426. PubMed PMID: 29790258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Distinguishing immunohistochemical features of alopecia areata from androgenic alopecia. AU - Kamyab,Kambiz, AU - Rezvani,Mohammad, AU - Seirafi,Hasan, AU - Mortazavi,Samira, AU - Teymourpour,Amir, AU - Abtahi,Shahab, AU - Nasimi,Maryam, Y1 - 2018/05/23/ PY - 2018/04/27/accepted PY - 2018/5/24/pubmed PY - 2019/5/18/medline PY - 2018/5/24/entrez KW - alopecia androgenic KW - alopecia areata KW - immunohistochemical stains SP - 422 EP - 426 JF - Journal of cosmetic dermatology JO - J Cosmet Dermatol VL - 18 IS - 1 N2 - BACKGROUND: Distinction between alopecia areata (AA) and androgenic alopecia (AGA) can be made according to clinical presentation and biopsy findings. However, it is sometimes difficult to differentiate them, especially when the diffuse pattern of both AA and AGA is in the differential diagnosis of hair loss in androgen-dependent areas. OBJECTIVES: To evaluate the characteristics of inflammatory cell infiltration using CD3, CD4, CD8, and CD20 antigens, in AA and AGA to find some consistent histological clues for distinguishing these two entities. METHODS: A retrospective analysis of patients with diagnosed AA (30 cases) and AGA (30 cases) was performed based on the clinical and histopathological criteria. We studied immunohistochemical findings for CD3, CD4, CD8, and CD20 in all selected cases. RESULTS: Immunohistochemical stains for CD4 and CD20 were not helpful in differentiating AA from AGA, but the inflammation density for AA was significantly (P-value = .025, .001) higher than AGA in CD3 (specificity= 86.7% and sensitivity= 96.7%) and CD8 (specificity= 50% and sensitivity=86.6%). Our findings revealed that intrafollicular CD3 (P-value = .017) and CD8 (P-value = ˂.001) infiltrations were significantly higher in AA samples in comparison with AGA. CONCLUSION: Characterization of CD3 and CD8 in IHC samples is helpful, especially when the density of CD3 and CD8 T cells are significant in more than 50% of the infiltrated cells and are located intrafolliculary. Moreover, the most specific and sensitive test for differentiating of AA from AGA is CD3. SN - 1473-2165 UR - https://www.unboundmedicine.com/medline/citation/29790258/Distinguishing_immunohistochemical_features_of_alopecia_areata_from_androgenic_alopecia_ DB - PRIME DP - Unbound Medicine ER -