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Utility of Horizontal Sections of Scalp Biopsies in Differentiating between Androgenetic Alopecia and Alopecia Areata.
Dermatology. 2018; 234(3-4):137-147.D

Abstract

BACKGROUND

Androgenetic alopecia (AGA) and alopecia areata (AA) are common causes of alopecia which can sometimes be difficult to differentiate clinically. Horizontal sections of scalp biopsies are used to study non-cicatricial alopecias due to the ability to perform both quantitative and morphometric analysis of hair follicles on them.

METHODS

It was a prospective, cross-sectional study conducted to assess the utility of horizontal sections to differentiate between the alopecias. Fifty-two cases were included: 20 cases of male AGA, 11 of female AGA and 21 cases of AA. After clinical examination and dermoscopy, a skin biopsy was taken and subjected to transverse sectioning. Histopathological assessment was done by two dermatopathologists blinded to clinical details.

RESULTS

Among the quantitative parameters, terminal:vellus hair ratio (3.08 in AGA and 1.83 in AA, p = 0.0091) and anagen:non-anagen hair ratio (9.25 in AGA and 3.56 in AA, p = 0.0021) were significantly lower in AA. In qualitative parameters, peribulbar inflammation was seen in 63% of AA cases (p = 0.0001). Pigment casts were seen in twice the number of AA (57%) than AGA (26%) cases. Broad avascular stelae and focal trichomalacia were seen in 9.5% of AA cases.

CONCLUSION

Besides peribulbar inflammation, we found a lower anagen:non-anagen hair ratio and presence of pigment casts in transverse sections of scalp biopsies favouring AA over AGA.

Authors+Show Affiliations

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30092597

Citation

Yadav, Deepika, et al. "Utility of Horizontal Sections of Scalp Biopsies in Differentiating Between Androgenetic Alopecia and Alopecia Areata." Dermatology (Basel, Switzerland), vol. 234, no. 3-4, 2018, pp. 137-147.
Yadav D, Khandpur S, Ramam M, et al. Utility of Horizontal Sections of Scalp Biopsies in Differentiating between Androgenetic Alopecia and Alopecia Areata. Dermatology. 2018;234(3-4):137-147.
Yadav, D., Khandpur, S., Ramam, M., Singh, M. K., & Sharma, V. K. (2018). Utility of Horizontal Sections of Scalp Biopsies in Differentiating between Androgenetic Alopecia and Alopecia Areata. Dermatology (Basel, Switzerland), 234(3-4), 137-147. https://doi.org/10.1159/000490459
Yadav D, et al. Utility of Horizontal Sections of Scalp Biopsies in Differentiating Between Androgenetic Alopecia and Alopecia Areata. Dermatology. 2018;234(3-4):137-147. PubMed PMID: 30092597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Utility of Horizontal Sections of Scalp Biopsies in Differentiating between Androgenetic Alopecia and Alopecia Areata. AU - Yadav,Deepika, AU - Khandpur,Sujay, AU - Ramam,M, AU - Singh,Manoj K, AU - Sharma,Vinod K, Y1 - 2018/08/09/ PY - 2018/03/21/received PY - 2018/05/23/accepted PY - 2018/8/10/pubmed PY - 2018/12/26/medline PY - 2018/8/10/entrez KW - Alopecia areata KW - Androgenetic alopecia KW - Histopathology KW - Horizontal sections KW - Scalp biopsy SP - 137 EP - 147 JF - Dermatology (Basel, Switzerland) JO - Dermatology VL - 234 IS - 3-4 N2 - BACKGROUND: Androgenetic alopecia (AGA) and alopecia areata (AA) are common causes of alopecia which can sometimes be difficult to differentiate clinically. Horizontal sections of scalp biopsies are used to study non-cicatricial alopecias due to the ability to perform both quantitative and morphometric analysis of hair follicles on them. METHODS: It was a prospective, cross-sectional study conducted to assess the utility of horizontal sections to differentiate between the alopecias. Fifty-two cases were included: 20 cases of male AGA, 11 of female AGA and 21 cases of AA. After clinical examination and dermoscopy, a skin biopsy was taken and subjected to transverse sectioning. Histopathological assessment was done by two dermatopathologists blinded to clinical details. RESULTS: Among the quantitative parameters, terminal:vellus hair ratio (3.08 in AGA and 1.83 in AA, p = 0.0091) and anagen:non-anagen hair ratio (9.25 in AGA and 3.56 in AA, p = 0.0021) were significantly lower in AA. In qualitative parameters, peribulbar inflammation was seen in 63% of AA cases (p = 0.0001). Pigment casts were seen in twice the number of AA (57%) than AGA (26%) cases. Broad avascular stelae and focal trichomalacia were seen in 9.5% of AA cases. CONCLUSION: Besides peribulbar inflammation, we found a lower anagen:non-anagen hair ratio and presence of pigment casts in transverse sections of scalp biopsies favouring AA over AGA. SN - 1421-9832 UR - https://www.unboundmedicine.com/medline/citation/30092597/Utility_of_Horizontal_Sections_of_Scalp_Biopsies_in_Differentiating_between_Androgenetic_Alopecia_and_Alopecia_Areata_ DB - PRIME DP - Unbound Medicine ER -