Lachapelle J M, Pierard G E
J Cutan Pathol. 1977;4(2):51-67. doi: 10.1111/j.1600-0560.1977.tb00890.x.
Ten patients with traumatic alopecia (trichotillomania) were being investigated histologically and, in five of them, hairs from the affected scalp area were plucked out for direct microscopic examination. Some histologic features appear to be specific markers for traumatic alopecia: empty hair ducts, plucked out hair bulbs, clefts in hair matrix, catagen involution of empty outer root sheaths, Miescher's trichomalacia in the deep dermis and torn-off sebaceous glands. Other signs are unspecific, such as presence of catagen and anagen VI hairs, infundibular plugging, melanin in keratin plugs and in the dermal papilla. The relative frequency of the different histopathologic features was evaluated. When little clinical information is available, a diagnosis of traumatic alopecia can be supported by skin biopsy. The histologic picture of trichotillomania is always incomplete, depending upon factors such as intensity of pulling or/and time of biopsy after plucking.
对10例创伤性脱发（拔毛癖）患者进行了组织学研究，其中5例患者从受影响的头皮区域拔出毛发进行直接显微镜检查。一些组织学特征似乎是创伤性脱发的特异性标志物：空的毛囊导管、拔出的毛球、毛基质中的裂隙、空的外根鞘的退行期退化、真皮深层的米舍尔毛软化症以及撕裂的皮脂腺。其他体征则不具有特异性，如存在退行期和生长期VI期毛发、漏斗部堵塞、角质栓和真皮乳头中的黑色素。评估了不同组织病理学特征的相对频率。当临床信息较少时，皮肤活检可支持创伤性脱发的诊断。拔毛癖的组织学表现总是不完整的，这取决于牵拉强度或/和拔毛后活检时间等因素。
