Tan Timothy, Guitart Joan, Gerami Pedram, Yazdan Pedram
Departments of Pathology, and.
Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Am J Dermatopathol. 2018 Apr;40(4):254-258. doi: 10.1097/DAD.0000000000000973.
Accurate identification of follicular streamers versus follicular scars on horizontal scalp biopsy sections is important to differentiate between cicatricial and noncicatricial alopecias. However, distinguishing between them can be difficult especially in nonoptimal specimens. The utility of elastic Verhoeff-Van Gieson (EVG) stain in cicatricial alopecias has been described on vertical sections, but its evaluation on horizontal sections has not been performed.
Sixty-four cicatricial alopecias (25 lichen planopilaris, 29 central centrifugal cicatricial alopecias, and 10 discoid lupus erythematosus) and 53 noncicatricial alopecias (34 androgenic alopecia, 8 telogen effluvium, and 11 alopecia areata) were identified, and EVG staining was performed on horizontal sections.
In follicular streamers, EVG highlighted an intact elastic network composed of delicate and thin elastic fibers circumferentially surrounding the angiofibrotic streamer without elastic network attenuation, loss, clumping, thickening, or recoil. In follicular scars, EVG demonstrated central attenuation and loss of the elastic network with peripheral clumping and recoil of elastic fibers.
In cases where distinguishing between follicular streamers and scars is difficult, EVG may be a helpful adjunctive tool in this regard and aid in allowing better discrimination between cicatricial and noncicatricial alopecias.
在水平头皮活检切片上准确鉴别毛囊束状结构与毛囊瘢痕，对于区分瘢痕性脱发和非瘢痕性脱发至关重要。然而，尤其是在非理想标本中，区分它们可能具有挑战性。弹性Verhoeff-Van Gieson（EVG）染色在垂直切片上用于瘢痕性脱发的效用已有描述，但尚未对其在水平切片上进行评估。
识别出64例瘢痕性脱发（25例扁平苔藓性毛囊角化病、29例中央离心性瘢痕性脱发和10例盘状红斑狼疮）和53例非瘢痕性脱发（34例雄激素性脱发、8例休止期脱发和11例斑秃），并对水平切片进行EVG染色。
在毛囊束状结构中，EVG突出显示一个完整的弹性网络，由纤细的弹性纤维周向环绕血管纤维性束状结构组成，无弹性网络衰减、缺失、聚集、增厚或回缩。在毛囊瘢痕中，EVG显示弹性网络中央衰减和缺失，伴有弹性纤维外周聚集和回缩。
在难以区分毛囊束状结构和瘢痕的情况下，EVG在这方面可能是一种有用的辅助工具，有助于更好地区分瘢痕性脱发和非瘢痕性脱发。
