Kulkarni Sai, Punia Rajpal Singh, Kundu Reetu, Thami Gurvinder Pal, Mohan Harsh
Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh, India.
Department of Dermatology and Venereology, Government Medical College and Hospital, Sector 32-A, Chandigarh, India.
Int J Trichology. 2014 Oct;6(4):164-7. doi: 10.4103/0974-7753.142859.
The present study was designed to categorize alopecia areata (AA) into various stages based on histopathology and further study the direct immunofluorescence (DIF) pattern.
The current study is noninterventional, prospective study on 25 consecutive patients suspected of AA based on clinical assessment. Histomorphologic features and immunoreactivity for IgG, IgM, IgA, and C3, was studied on biopsy material.
Age of the patients ranged from 6 years to 48 years with a mean age of 28.56 ± 21.8 years. Majority of patients, 9 (36%) were in the age group of 21-30 years. Of 25 patients, 13 (52%) were males and 12 (48%) were females. Male: female ratio was 1.1:1. On histopathology majority of cases were in subacute stage 9 (36%), followed by chronic 7 (28%), acute 5 (20%) and recovery stages 4 (16%). Three (12%) of 4 cases showed characteristic swarm of bees appearance. Two (8%) of the cases showed presence of giant cells. Increased numbers of catagen hair were seen in 12 (48%) cases. Of 25 cases, 9 (36%) cases showed positive DIF with granular deposits. The most common immunoreactant was IgG in 7 (28%) cases, followed by IgA in 4 (16%), C3 in 6 (24%) and IgM in 3 (12%) cases. Of 9 cases showing positive staining, 3 (12%) were in acute stage and 2 (8%) each in subacute, chronic and recovery stages.
The observations further reiterate that immune mechanisms play a role in the pathogenesis of AA.
本研究旨在根据组织病理学将斑秃（AA）分为不同阶段，并进一步研究直接免疫荧光（DIF）模式。
本研究为非干预性前瞻性研究，对25例经临床评估疑似患有AA的连续患者进行研究。对活检材料进行组织形态学特征及IgG、IgM、IgA和C3免疫反应性研究。
患者年龄范围为6岁至48岁，平均年龄为28.56±21.8岁。大多数患者，即9例（36%）处于21 - 30岁年龄组。25例患者中，13例（52%）为男性，12例（48%）为女性。男女比例为1.1:1。组织病理学检查显示，大多数病例处于亚急性期9例（36%），其次为慢性期7例（28%）、急性期5例（20%）和恢复期4例（16%）。4例中有3例（12%）表现出特征性的蜂群样外观。2例（8%）病例出现巨细胞。12例（48%）病例可见生长期毛发数量增加。25例中，9例（36%）病例DIF呈阳性，有颗粒状沉积。最常见见见常见的免疫反应物为IgG，7例（28%），其次为IgA 4例（16%）、C3 6例（24%）和IgM 3例（12%）。9例染色阳性病例中，3例（12%）处于急性期，亚急性期、慢性期和恢复期各2例（8%）。
这些观察结果进一步重申免疫机制在斑秃发病机制中起作用。
