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Histopathologic and dermoscopic features of 42 cases of folliculitis decalvans: a case series.
J Am Acad Dermatol. 2020 Apr 06 [Online ahead of print]JA

Abstract

BACKGROUND

Folliculitis decalvans (FD) is a form of inflamed primary cicatricial alopecia (PCA). FD is classified as a neutrophilic PCA; however, only a few previous studies have described its histopathology, including the assessment of systematically evaluated and quantified follicular changes in horizontally sectioned biopsy specimens with clinical and dermoscopic findings of the early and advanced stages.

OBJECTIVE

We aimed to clarify the histopathological and dermoscopic features of early and advanced active stage FD.

METHODS

We conducted a case series study of 42 patients with FD by dermoscopy and both horizontally and vertically sectioned biopsy specimens.

RESULTS

The histopathological findings of the early-stage lesions included loss of sebaceous glands, interfollicular acanthosis, and fibrosis with depressed, fused follicular infundibula showing thickened interfollicular keloid-like areas with tufted hairs on dermoscopy. Active lesions revealed a greater number of hair clusters, clefting, and fused infundibula with dense inflammation predominantly in the upper follicles. Neutrophil-predominant infiltrates were observed in less than half the patients, including those with early-stage lesions.

LIMITATIONS

This was a retrospective study.

CONCLUSION

FD has the features of mixed cell-PCA. The features of early-stage FD are thickened interfollicular keloid-like areas with tufted hairs and loss of sebaceous glands.

Authors+Show Affiliations

Department of Dermatology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan. Electronic address: masa777@tokyo-med.ac.jp.Department of Dermatology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.Department of Dermatology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.Department of Dermatology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.Department of Dermatology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32272176

Citation

Uchiyama, Masaki, et al. "Histopathologic and Dermoscopic Features of 42 Cases of Folliculitis Decalvans: a Case Series." Journal of the American Academy of Dermatology, 2020.
Uchiyama M, Harada K, Tobita R, et al. Histopathologic and dermoscopic features of 42 cases of folliculitis decalvans: a case series. J Am Acad Dermatol. 2020.
Uchiyama, M., Harada, K., Tobita, R., Irisawa, R., & Tsuboi, R. (2020). Histopathologic and dermoscopic features of 42 cases of folliculitis decalvans: a case series. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2020.03.092
Uchiyama M, et al. Histopathologic and Dermoscopic Features of 42 Cases of Folliculitis Decalvans: a Case Series. J Am Acad Dermatol. 2020 Apr 6; PubMed PMID: 32272176.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Histopathologic and dermoscopic features of 42 cases of folliculitis decalvans: a case series. AU - Uchiyama,Masaki, AU - Harada,Kazutoshi, AU - Tobita,Rie, AU - Irisawa,Ryokichi, AU - Tsuboi,Ryoji, Y1 - 2020/04/06/ PY - 2019/04/22/received PY - 2020/03/17/revised PY - 2020/03/30/accepted PY - 2020/4/10/entrez PY - 2020/4/10/pubmed PY - 2020/4/10/medline KW - alopecia KW - cicatricial alopecia KW - dermoscopy KW - folliculitis decalvans KW - histology KW - horizontal sections KW - scarring alopecia KW - transverse sections KW - trichoscopy KW - tufted folliculitis KW - vertical sections JF - Journal of the American Academy of Dermatology JO - J. Am. Acad. Dermatol. N2 - BACKGROUND: Folliculitis decalvans (FD) is a form of inflamed primary cicatricial alopecia (PCA). FD is classified as a neutrophilic PCA; however, only a few previous studies have described its histopathology, including the assessment of systematically evaluated and quantified follicular changes in horizontally sectioned biopsy specimens with clinical and dermoscopic findings of the early and advanced stages. OBJECTIVE: We aimed to clarify the histopathological and dermoscopic features of early and advanced active stage FD. METHODS: We conducted a case series study of 42 patients with FD by dermoscopy and both horizontally and vertically sectioned biopsy specimens. RESULTS: The histopathological findings of the early-stage lesions included loss of sebaceous glands, interfollicular acanthosis, and fibrosis with depressed, fused follicular infundibula showing thickened interfollicular keloid-like areas with tufted hairs on dermoscopy. Active lesions revealed a greater number of hair clusters, clefting, and fused infundibula with dense inflammation predominantly in the upper follicles. Neutrophil-predominant infiltrates were observed in less than half the patients, including those with early-stage lesions. LIMITATIONS: This was a retrospective study. CONCLUSION: FD has the features of mixed cell-PCA. The features of early-stage FD are thickened interfollicular keloid-like areas with tufted hairs and loss of sebaceous glands. SN - 1097-6787 UR - https://www.unboundmedicine.com/medline/citation/32272176/Histopathologic_and_dermoscopic_features_of_42_cases_of_folliculitis_decalvans:_a_case_series L2 - https://linkinghub.elsevier.com/retrieve/pii/S0190-9622(20)30515-6 DB - PRIME DP - Unbound Medicine ER -
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