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Scalp Biopsy (scalp + biopsy)

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Medical Sciences	100%

Selected Abstracts

A case report of inflammatory nonscarring alopecia associated with the epidermal growth factor receptor inhibitor erlotinib

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 12 2009
Marinya Pongpudpunth
Epidermal growth factor receptor inhibitors (EGFRIs) are new anticancer agents that act by inhibiting EGFR signaling transduction pathways, thus decreasing tumor growth. In more than 30 countries, EGFRIs are currently used in the treatment of a number of solid tumors, and other indications are being sought. In the United States, select EGFRIs have been approved in certain patients with non-small cell lung cancer, metastatic colorectal carcinoma, and advanced squamous cell carcinoma of the head and neck. Various cutaneous side effects of EGFRIs have been reported, including acneiform eruptions, chronic paronychia, xerosis, a seborrheic dermatitis-like eruption, changes in hair texture, and nonscarring alopecia. We present a 60-year-old woman with non-small cell lung cancer who developed a persistent generalized itchy eruption and progressive nonscarring alopecia shortly after initiation of erlotinib (Tarceva). Scalp biopsy showed near-equal number of anagen and catagen/telogen hair follicles, and a superficial and deep perivascular lymphoplasmocytic infiltration. These changes are typical of the nonscarring alopecia induced by EGFRIs. Because it is likely that EGFRIs will be increasingly used, dermatopathologists are likely to see more reactions from these agents. Familiarity with their side effects is essential to accurate diagnosis and effective patient management. [source]

The histopathology of alopecia areata in vertical and horizontal sections

DERMATOLOGIC THERAPY, Issue 4 2001
David A. Whiting
Alopecia areata (AA) is a relatively common disease affecting 1.7% of Americans by the age of 50 years. The diagnosis is usually made on clinical grounds. In some cases the diagnosis is elusive and biopsies are necessary. In other cases biopsies are useful from a prognostic point of view to determine whether there are enough follicles left for possible future regrowth. In view of the active research being conducted into AA, biopsies provide valuable material for further investigation. The diagnosis of AA is improved by the use of horizontal sections in addition to or instead of vertical sections of scalp biopsies. The histopathologic features favoring the diagnosis of AA include peribulbar and intrabulbar mononuclear infiltrates, degenerative changes in the hair matrix, decreased numbers of terminal anagen follicles, increased numbers of terminal catagen and telogen follicles, an increased number of follicular stelae, an increased number of miniaturized vellus hair follicles, and pigment incontinence of hair bulbs and follicular stelae. Follicular counts with horizontal sections are particularly helpful in making the diagnosis of AA when the biopsy has been taken between acute episodes and the characteristic peribulbar inflammatory infiltrate is absent. [source]

The lack of significant changes in scalp hair follicle density with advancing age

BRITISH JOURNAL OF DERMATOLOGY, Issue 4 2005
R. Sinclair
Summary Background, Age-related reduction in hair is seen in the axillary and pubic regions as well as the scalp; however, it has not been investigated qualitatively on the scalp. Horizontally sectioned scalp biopsy is an ideal tool to investigate the impact of advancing age on scalp hair follicle density and morphology. Objectives, To examine the effect of age and follicle miniaturization on total hair count in 1666 horizontally sectioned mid-scalp biopsies from 928 women aged between 13 and 84 years with hair loss. Methods Setting:, Specialist hair loss referral clinic in a teaching hospital. Design: Analysis of data set. Methods:, All scalp biopsies were 4 mm in diameter and taken from the crown. Miniaturization was assessed by calculating the ratio of terminal to vellus-like hairs (T/V) at the mid-isthmus level and considered significant if the ratio was , 4 : 1. Fibrosis was documented when present. Linear regression was used to examine the association between total hair count, age and miniaturization. Results, The average number of hair follicles per biopsy was 39·6 (SD ± 10·8). A highly significant negative association (P < 0·0001) was found between age and total follicle number, although the predictive value of age in total hair count was found to be small [root error mean square (R2) < 2%]. Controlling for T/V , 4 : 1, the association was weakened, but remained significant. The relationship unconfounded by T/V , 4 : 1 shows that for every additional year of ageing, 0·077 total hair follicles (0·22%) are lost per biopsy. Conclusions, Age and follicular miniaturization were found to be extremely weak predictors of total hair count in women with hair loss. [source]

Sporadic dystrophic epidermolysis bullosa with albopapuloid and prurigo- and folliculitis-like lesions

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 8 2009
Yi-Ming Fan MD
A case of sporadic dystrophic epidermolysis bullosa (DEB) with albopapuloid and prurigo- and folliculitis-like lesions is reported. Histopathology of the scalp biopsy showed hyperkeratosis, a subepidermal cleft near the orifice of a hair follicle, dermal fibrosis, and a moderate perivascular and perifollicular lymphohistiocytic inflammatory cell infiltrate in the papillary dermis, without neutrophilic infiltrate in the orifice of the hair follicle. It is uncertain whether the present case should be classified as DEB pruriginosa or represents a new subtype of DEB. [source]

The lack of significant changes in scalp hair follicle density with advancing age

Androgenetic alopecia in children: report of 20 cases

BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2005
A. Tosti
Summary Androgenetic alopecia (AGA) is the most common type of hair loss in adults. Although there are differences in the age at onset, the disease starts after puberty when enough testosterone is available to be transformed into dihydrotestosterone. We report 20 prepubertal children with AGA, 12 girls and eight boys, age range 6,10 years, observed over the last 4 years. All had normal physical development. Clinical examination showed hair loss with thinning and widening of the central parting of the scalp, both in boys and girls. In eight cases frontal accentuation and breach of frontal hairline were also present. The clinical diagnosis was confirmed by pull test, trichogram and dermoscopy in all cases, and by scalp biopsy performed in six cases. There was a strong family history of AGA in all patients. The onset of AGA is not expected to be seen in prepubertal patients without abnormal androgen levels. A common feature observed in our series of children with AGA was a strong genetic predisposition to the disease. Although the pathogenesis remains speculative, endocrine evaluation and a strict follow-up are strongly recommended. [source]

There is no clear association between low serum ferritin and chronic diffuse telogen hair loss

BRITISH JOURNAL OF DERMATOLOGY, Issue 5 2002
R. Sinclair
SummaryBackground Low iron stores are considered a possible cause of chronic diffuse telogen hair loss in women. Estimation of serum ferritin is recommended as part of the initial assessment when women present with chronic diffuse telogen hair loss, and iron supplementation therapy is commonly recommended for those found to have low iron stores. Objectives To evaluate the relationship between low serum ferritin (,20 µg L,1) and chronic diffuse telogen hair loss in women. Methods Between 1997 and 1999, 194 consecutive women who presented to a specialist hair clinic were assessed for diffuse telogen hair loss of greater than 6 months duration. All underwent biochemical investigations that included serum ferritin and had two 4-mm punch biopsies taken from the vertex of the scalp. One biopsy was sectioned horizontally and the other vertically. Results Twelve women were found to have a serum ferritin of 20 µg L,1 or less (6·2%). Androgenetic alopecia was found on scalp biopsy in seven of these 12 women, while the other five women had normal histology. The five women with low iron stores and normal histology were treated with iron supplementation alone. This was continued until the serum ferritin was > 20 µg L,1. Cessation or reversal of hair loss was not seen in any of these women. Conclusions No direct relationship between low serum ferritin and hair loss can be established. The usefulness of serum ferritin in the routine investigation of women with chronic diffuse telogen hair loss is unclear, as is the role of iron supplementation therapy in the management of hair loss. [source]