Scarring versus non-scarring alopecia: comparative histomorphological study

Abstract

The hair has sensory, thermoregulation, physical protection functions and is strongly related to people's self-esteem. The alopecias are conditions in which there is a decrease or absence of hair. They alter the physical appearance of the individual and often cause a negative psychological impact. Alopecias are classified under different approaches. Regarding the possibility of inflammatory destruction of the hair follicles, in scarring and non-scarring. In the daily practice, the pathologist frequently receives scalp biopsies in which the clinical hypotheses are both scarring and non-scarring alopecia for the same patient. As an example, we can have diagnostic hypotheses of alopecia areata versus fibrous frontal alopecia. This fact demonstrates that, either, through the clinical and dermatoscopic point of view, distinguishing these two large groups of alopecia is not a simple procedure. To aggravate this problem, from the histological examination, it is sometimes difficult to distinguish processes that cause permanent destruction of the follicles from those in which the follicles are not identified in the tissue sample. Scarring alopecia should be readily identified as evolves with definitive loss of the follicle. The morphological study of scalp biopsies of alopecias, comparatively with clinical, dermatoscopic, and course can help to define findings that facilitate reaching the diagnosis in dubious cases. The aim of this work is to identify histological elements that allow the differentiation of cicatricial from non-cicatricial alopecia. The clinical, laboratory and clinical course information of patients who were treated with complaints of alopecia and the respective histopathological samples of the scalp will be evaluated. The results will be correlated with each other and with the final nosological diagnosis. (AU)