Departments of Dermatology and Dermatopathology, Saint-Pierre, Brugmann and Queen Fabiola Children's University Hospitals, Université Libre de Bruxelles, Brussels, Belgium.
Departments of Biomedical Engineering, Pathology, and Dermatology, Oregon Health Sciences University, Portland, Oregon.
J Am Acad Dermatol. 2016 May;74(5):937-44. doi: 10.1016/j.jaad.2015.12.011. Epub 2016 Feb 3.
Distinguishing between diffuse subacute alopecia areata (AA), in which the peribulbar infiltrate is absent, and pattern hair loss is challenging, particularly in cases that lack marked follicular miniaturization and a marked catagen/telogen shift.
We sought to distinguish diffuse AA from pattern hair loss using CD3(+) T lymphocytes.
A total of 28 cases of subacute AA and 31 cases of pattern hair loss were selected and a 4-mm punch biopsy was performed. All the specimens were processed using the "HoVert" (horizontal and vertical) technique. In all cases, hematoxylin-eosin and immunohistochemical stains for CD3, CD4, CD8, and CD20 were performed.
The presence of CD3(+) lymphocytes within empty follicular fibrous tracts (stela), even without a concomitant peribulbar infiltrate, is a reliable histopathological clue in supporting a diagnosis of AA (sensitivity 0.964, specificity 1, P ≤ .001).
Limited tissue for analysis remained in the clinical sample tissue blocks.
The presence of CD3(+) T-cells within empty follicular fibrous tracts (stela) supports a diagnosis of AA.
区分弥漫性亚急性斑秃（AA）和模式性脱发具有一定挑战性，尤其是在那些缺乏明显毛囊微小化和明显的休止期/退行期转变的病例中。弥漫性 AA 中不存在眶周浸润。
我们试图使用 CD3(+)T 淋巴细胞来区分弥漫性 AA 和模式性脱发。
选择了 28 例亚急性 AA 和 31 例模式性脱发病例，并进行了 4mm 打孔活检。所有标本均采用“HoVert”（水平和垂直）技术处理。所有病例均进行了苏木精-伊红和 CD3、CD4、CD8 和 CD20 的免疫组织化学染色。
即使没有伴随眶周浸润，在空的毛囊纤维束（stela）中存在 CD3(+)淋巴细胞是支持 AA 诊断的可靠组织病理学线索（敏感性 0.964，特异性 1，P≤0.001）。
临床样本组织块中仍有有限的组织可供分析。
空的毛囊纤维束（stela）中存在 CD3(+)T 细胞支持 AA 的诊断。
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