Goyal Mankul, Khandpur Sujay, Ramam M, Sharma Vinod Kumar, Singh Manoj Kumar
Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Indian J Dermatol. 2019 Jan-Feb;64(1):47-54. doi: 10.4103/ijd.IJD_477_17.
Transverse sections of scalp biopsies are performed for the assessment of alopecias and are considered advantageous over vertical sections.
The aim was to study the histopathological features of alopecias on transverse sections of scalp biopsies.
It was a descriptive study. Clinically confirmed cases of noncicatricial and cicatricial alopecias were subjected to 4 mm scalp biopsies, which were sectioned transversely and analyzed. Biopsies obtained from occipital region of androgenetic alopecia (AGA) cases were taken as controls.
Biopsies from 41 cases were assessed, including male and female AGA, alopecia areata (AA), trichotillomania, lichen planopilaris (LPP), discoid lupus erythematosus (DLE), and folliculitis decalvans (FD). Normal scalp (control) biopsies showed the median total number of hair follicles of 35 (32-37), anagen:telogen/catagen ratio of 17.5 (16.5-31), and terminal:vellus ratio of 15 (10.7-17.5). In AGA and AA, miniaturization and shift toward telogen and catagen hair were consistently observed. Peribulbar inflammation was seen in two-third of AA. Trichotillomania showed increased catagen hair and numerous pigment casts. In DLE, besides perifollicular inflammation, prominent peri-arrector pili and peri-eccrine inflammation were observed. Type of inflammatory infiltrate was similar in DLE and LPP (lymphocytic), whereas FD showed neutrophilic and plasma cell infiltrate, both around follicles and interstitially. Basal cell damage in the follicles and pigment incontinence were seen in majority of DLE and LPP patients. DLE also showed basement membrane thickening, mucin deposition, and telangiectasia. Reduction/absence of sebaceous glands and perifollicular fibrosis were observed in almost all cicatricial alopecias.
Transverse sectioning may be a useful tool in the diagnosis of alopecias.
头皮活检的横切面用于脱发的评估，被认为比纵切面更具优势。
研究头皮活检横切面上脱发的组织病理学特征。
这是一项描述性研究。临床确诊的非瘢痕性和瘢痕性脱发病例接受4毫米头皮活检，将其横切并进行分析。取自雄激素性脱发（AGA）病例枕部区域的活检组织作为对照。
评估了41例患者的活检组织，包括男性和女性AGA、斑秃（AA）、拔毛癖、扁平苔藓样毛发角化病（LPP）、盘状红斑狼疮（DLE）和脱发性毛囊炎（FD）。正常头皮（对照）活检显示毛囊总数中位数为35（32 - 37），生长期与休止期/退行期比例为17.5（16.5 - 31），终毛与毳毛比例为15（10.7 - 17.5）。在AGA和AA中，始终观察到毛囊小型化以及向休止期和退行期毛发的转变。三分之二的AA可见球周炎症。拔毛癖显示退行期毛发增多和大量色素管型。在DLE中，除了毛囊周围炎症外，还观察到明显的立毛肌周围和汗腺周围炎症。DLE和LPP中的炎症浸润类型相似（淋巴细胞性），而FD显示中性粒细胞和浆细胞浸润，在毛囊周围和间质均有。大多数DLE和LPP患者可见毛囊基底细胞损伤和色素失禁。DLE还显示基底膜增厚、黏蛋白沉积和毛细血管扩张。几乎所有瘢痕性脱发均观察到皮脂腺减少/缺失和毛囊周围纤维化。
横切面检查可能是脱发诊断中的一种有用工具。
