ABSTRACT
Objective To compare diagnostic performance of traditional vertical section technique,horizontal section technique and modified Ho-Vert technique for classical lichen planopilaris.Methods Clinical data were collected from patients with classical lichen planopilaris in Department of Dermatology,The Affiliated Wuxi People's Hospital of Nanjing Medical University from January 1st 2015 to January 1st 2019.With the help of dermoscopy,2 scalp specimens were obtained from each patient and sliced horizontally and vertically respectively by using modified Ho-Vert technique.The horizontal and vertical sections were read separately or simultaneously,and histopathological changes were observed.Results Totally,21 patients with classical lichen planopilaris were enrolled into this study,including 15 males and 6 females.Their age was 50.0 ± 13.6 years,and the average course of disease was 18 months.The patients mainly presented with muhifocal or confluent patchy hair loss,and scalp atrophy,perifollicular hyperkeratosis,loss of follicular ostia,fibrous white dots and orbit sign were observed.On the horizontal sections,lichenoid lymphocytic infiltration around the infundibulum and isthmus of hair follicles and follicular micro-scars could be observed in all patients,and the dermo-epidermal interface could be seen in 7 patients.On the vertical sections,lichenoid lymphocytic infiltration around the infundibulum and isthmus of hair follicles only could be observed in 9 patients,follicular micro-scars could be seen in 4,and the dermoepidermal interface could be observed in all patients.Moreover,the detection rates of interfollicular interface dermatitis,follicular keratotic plugs,lymphocytic infiltration around sebaceous glands,atrophy or disappearance of sebaceous glands and inflammatory infiltration around hair follicle bulbs were significantly different between the horizontal and vertical sections.In combination with clinical manifestations,7 patients could be exactly diagnosed with lichen planopilaris according to findings from horizontal sections,and 9 could be diagnosed exactly according to findings from vertical sections,while 21 could be diagnosed exactly according to histopathological findings from both horizontal and vertical sections.Conclusion With the help of dermoscopy,modified Ho-Vert technique can improve the efficacy of pathological diagnosis of classical lichen planopilaris,by multidimensionally showing histopathological changes.
ABSTRACT
Objective@#To compare diagnostic performance of traditional vertical section technique, horizontal section technique and modified Ho-Vert technique for classical lichen planopilaris.@*Methods@#Clinical data were collected from patients with classical lichen planopilaris in Department of Dermatology, The Affiliated Wuxi People′s Hospital of Nanjing Medical University from January 1st 2015 to January 1st 2019. With the help of dermoscopy, 2 scalp specimens were obtained from each patient and sliced horizontally and vertically respectively by using modified Ho-Vert technique. The horizontal and vertical sections were read separately or simultaneously, and histopathological changes were observed.@*Results@#Totally, 21 patients with classical lichen planopilaris were enrolled into this study, including 15 males and 6 females. Their age was 50.0 ± 13.6 years, and the average course of disease was 18 months. The patients mainly presented with multifocal or confluent patchy hair loss, and scalp atrophy, perifollicular hyperkeratosis, loss of follicular ostia, fibrous white dots and orbit sign were observed. On the horizontal sections, lichenoid lymphocytic infiltration around the infundibulum and isthmus of hair follicles and follicular micro-scars could be observed in all patients, and the dermo-epidermal interface could be seen in 7 patients. On the vertical sections, lichenoid lymphocytic infiltration around the infundibulum and isthmus of hair follicles only could be observed in 9 patients, follicular micro-scars could be seen in 4, and the dermo-epidermal interface could be observed in all patients. Moreover, the detection rates of interfollicular interface dermatitis, follicular keratotic plugs, lymphocytic infiltration around sebaceous glands, atrophy or disappearance of sebaceous glands and inflammatory infiltration around hair follicle bulbs were significantly different between the horizontal and vertical sections. In combination with clinical manifestations, 7 patients could be exactly diagnosed with lichen planopilaris according to findings from horizontal sections, and 9 could be diagnosed exactly according to findings from vertical sections, while 21 could be diagnosed exactly according to histopathological findings from both horizontal and vertical sections.@*Conclusion@#With the help of dermoscopy, modified Ho-Vert technique can improve the efficacy of pathological diagnosis of classical lichen planopilaris, by multidimensionally showing histopathological changes.
ABSTRACT
Alopecia is a common disease in dermatologic clinics.The diagnosis of some hair diseases does not rely on pathological examinations,and with the development of science and technology,the role of many new non-invasive detection instruments,such as dermoscopy,hair scanners and skin CT,is increasingly valued in the diagnosis and treatment of hair diseases.However,the role of pathological examination is still irreplaceable.Because of the particularity of hair diseases,hair pathology differs from common skin pathology in the aspects of scalp biopsy sites,biopsy methods and techniques,tissue-slicing methods and pathological report content.This review systematically discusses the role of scalp pathological biopsy in the diagnosis and treatment of alopecia.
ABSTRACT
La dermatoscopía es una técnica muy útil no solo en lesiones melanocíticas sino también en otras alteraciones de diferente etiología. El pelo es asiento de variadas enfermedades que en muchas ocasiones dan origen a dudas diagnósticas. El examen dermatoscópico permite en unos casos magnificar claramente las lesiones que clínicamente ya son apreciables y en otros casos identifica signos propios de cada enfermedad que son una ayuda para el diagnóstico. En el presente estudio se revisan casos de patología capilar en niños y se escogen cuatro enfermedades con diagnóstico comprobado y con registro iconográfico tanto clínico como dermatoscópico: alopecia areata, tricotilomanía, tricorrexis nodosa localizada adquirida y tiña tricofítica. Se reportan las características dermatoscópicas capilares en cada enfermedad y se establecen patrones cuando esto es posible; finalmente se recomienda la aplicación de esta técnica en forma más amplia tanto por su bajo costo como por su fácil acceso (AU)
Dermatoscopy is a very useful technique not only for melanocytic lesions, but also for other cutaneous conditions of different etiology.The diagnosis of many disorders that affect hair and scalp can be challenging for the dermatologist. With the aid of the dermatoscopic examination, hair and scalp lesions that are observed clinically can be magnified, allowing us to identify certain signs and patterns that can help in the diagnosis.We describe the patterns of four hair disorders including, alopecia areata, trichotylomania, localized acquired trichorrhexis nodosa and tinea capitis. The charactheristic dermatoscopic findings, as well as the patterns that were observed in our patients are presented. Finally, due to its low cost and friendly use we suggest the application of this helpful tool to identify and diagnose the conditions described above (AU)