The most important clinical input necessary for biopsy interpretation is whether the alopecia is scarring or non-scarring. It will address only the common diseases and their diagnostic challenges. This review attempts to bridge these gaps and address issues of practical significance. An important point to bear in mind is that classic lesions are rarely biopsied and chances of finding overlaps, confounding and atypical features on biopsies are quite frequent. Many pathologists are unfamiliar with the special handling required for these biopsies right from the level of grossing to interpretation. It is also the most objective method to estimate/predict the response to treatment. It is the single most important tool in understanding disease pathogenesis and yet is underutilized. The presently followed NAHRS classification of scarring/cicatricial alopecia according to the nature of the dominant inflammatory cell infiltrate is based purely on morphology. ,, , Of these, the contribution of histopathology is paramount. The causes of alopecia are diverse, and a specific diagnosis is made by a concert of detailed clinical history, accurate description of lesions, histopathologic evaluation of scalp biopsies taken from appropriate sites, and sometimes, special techniques such as direct immunofluorescence (DIF).
Available from: Īlopecia is a common disorder in India. Indian J Dermatopathol Diagn Dermatol 2018 5:79-88. How to cite this URL: Yeliur IK, Tirumalae R. Indian J Dermatopathol Diagn Dermatol 2018 5:79-88
How to cite this article: Yeliur IK, Tirumalae R. Keywords: Alopecia, histopathology, non-scarring alopecia, scarring alopecia Some of the diagnostic challenges are also highlighted. It emphasizes the importance of examining the biopsy under scanning magnification, which is often overlooked and can provide vital clues. This review attempts to give an overview of hair anatomy and histology and discusses a simple, practical, microscopy-based classification of the commonly encountered diseases. Histopathology is the most valuable tool in diagnosis. From the therapeutic and prognostic point of view, it is vital to discriminate between scarring and nonscarring alopecia. Its' classification is still evolving, and there are several areas of overlap. DOI: 10.4103/ijdpdd.ijdpdd_48_18 AbstractĪlopecia is a common condition that frequently poses a challenge to pathologists and dermatologists alike.
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