Sari Aslani Fatemeh, Heidari Esfahani Mina, Sepaskhah Mozhdeh
Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Dept. of Pathology, Valiasr Hospital, Fasa University of Medical Sciences, Fasa, Iran.
Iran J Pathol. 2018 Summer;13(3):317-324. Epub 2018 Sep 12.
Non-scarring alopecia is a challenge in the diagnosis and treatment, rarely studied in Asian countries.The current study aimed at evaluating histopathological features including hair count of different subtypes of non-scarring alopecia in Iranian patients.
The current study was conducted on 114 cases diagnosed with non-scarring alopecia in Molecular Dermatology Research Center and Pathology Department of Shiraz University of Medical Sciences, Shiraz, Iran. Cases with two 4-mm scalp punch biopsies were selected. Patients' clinical data were compared with histological findings.
Androgenetic alopecia (AGA) was the most common subtype followed by alopecia areata (AA) and combined AGA/telogen effluvium (TE). Perifollicular inflammation was observed in 21% of AGA with a significant difference in males and females (66.7% vs. 33.3%; <0.05). Clinical and histopathologic diagnoses were correlated in 55% of cases. Maximum correlation was observed in combined AGA and chronic TE (88%). For vertical sections, the diagnostic rate was 33.6%, while 88% for transverse sections.
Transverse together with vertical sectioning provides most of the information in non-scarring alopecias, while transverse sectioning is enough to diagnose the majority of non-scarring alopecias. Perifollicular inflammation was observed in a significant number of cases with AGA, more common in males. It is suggested to report such cases as possibly curable.
非瘢痕性脱发在诊断和治疗方面具有挑战性,在亚洲国家鲜有研究。本研究旨在评估伊朗患者非瘢痕性脱发不同亚型的组织病理学特征,包括毛发计数。
本研究对伊朗设拉子医科大学分子皮肤病研究中心和病理科诊断为非瘢痕性脱发的114例患者进行。选取有两块4毫米头皮打孔活检组织的病例。将患者的临床数据与组织学结果进行比较。
雄激素性脱发(AGA)是最常见的亚型,其次是斑秃(AA)和AGA/休止期脱发(TE)合并型。21%的AGA患者观察到毛囊周围炎症,男性和女性有显著差异(66.7%对33.3%;P<0.05)。55%的病例临床诊断与组织病理学诊断相关。在AGA和慢性TE合并型中观察到的相关性最高(88%)。对于纵切片,诊断率为33.6%,而横切片为88%。
横切片与纵切片相结合可提供非瘢痕性脱发的大部分信息,而横切片足以诊断大多数非瘢痕性脱发。在大量AGA病例中观察到毛囊周围炎症,在男性中更常见。建议将此类病例报告为可能可治愈。